| Name: | Salame Heart and Vascular Clinic, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 04 Mar 2009 (16 years ago) (Companies founded in March 2009) |
| Entity Number: | 000-431-160 |
| Register Number: | 000431160 |
| ZIP code: | 36207 (Companies in Calhoun, 36207) |
| County: | Calhoun |
| Place of Formation: | Calhoun County |
| Principal Address: | ANNISTON, AL |
| Registered Office Street Address: | 901 LEIGHTON AVE STE 702ANNISTON, AL 36207 |
Activities
PROVIDE MEDICAL CARE/TREATMENT
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437390184 | 2009-03-10 | 2019-01-22 | PO BOX 1440, ANNISTON, AL, 362021440, US | 1031 QUINTARD AVE STE 1A, ANNISTON, AL, 362015714, US | |||||||||||||||||||||||||||||
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| Phone | +1 256-689-0147 |
| Fax | 2562363657 |
| Phone | +1 256-231-2552 |
| Fax | 2562312550 |
Authorized person
| Name | DR. MAHOMED Y SALAME |
| Role | PRESIDENT |
| Phone | 2566890147 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | 25751 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 111755 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| SALAME, MAHOMED | Agent | 1700 CHRISTINE AVENUEANNISTON, AL 36207 |
| Name | Role | Address |
|---|---|---|
| SALAME, MAHOMED | Member | 1700 CHRISTINE AVENUEANNISTON, AL 36207 |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
