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Vestavia Surgical Center, LLC

Details

Name: Vestavia Surgical Center, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Dissolved
Date of registration: 25 Feb 2010 (15 years ago)
Date of dissolution: 25 Feb 2020
Entity Number: 000-443-871
Register Number: 000443871
County: Jefferson
Place of Formation: Jefferson County
Principal Address: BIRMINGHAM, AL
Registered Office Street Address: 700 MONTGOMERY HWY STE 210BIRMINGHAM, AL 35216
Registered Office Street Address ZIP Code: 35216

Activities MEDICAL PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1114367604 2013-06-27 2013-06-27 700 MONTGOMERY HWY, SUITE 210, VESTAVIA, AL, 352161866, US 700 MONTGOMERY HWY, SUITE 210, VESTAVIA, AL, 352161866, US

Contacts

Phone +1 205-823-0150
Fax 2058235218

Authorized person

Name DR. JOHN R KINGSLEY
Role PRESIDENT & OWNER
Phone 2058230151

Taxonomy

Taxonomy Code 261QA1903X - Ambulatory Surgical Clinic/Center
License Number 443871
State AL
Is Primary Yes

Agent

Name Role
KINGSLEY, JOHN R Agent

Member

Name Role
KINGSLEY, JOHN R Member

Date of last update: 13 Aug 2024

Sources: Alabama Secretary of State