| Name: | Dark Side Medical LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 09 Apr 2010 (15 years ago) |
| Entity Number: | 000-445-754 |
| Register Number: | 000445754 |
| County: | Shelby |
| Place of Formation: | Montgomery County |
| Principal Address: | MONTGOMERY, AL |
| Registered Office Street Address: | 5130 CYRUS CIRCLEBIRMINGHAM, AL 35242 |
| Registered Office Street Address ZIP Code: | 35242 |
Activities
MEDICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1609153030 | 2011-11-14 | 2011-11-14 | 5130 CYRUS CIR, BIRMINGHAM, AL, 352424630, US | 5130 CYRUS CIR, BIRMINGHAM, AL, 352424630, US | |||||||||||||||||||||
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| Phone | +1 205-981-0414 |
| Fax | 8883806501 |
| Fax | 8883306501 |
Authorized person
| Name | DR. VICTOR ESTRADA MENDOZA |
| Role | OWNER AND TREATING PHYSICIAN |
| Phone | 2569976182 |
Taxonomy
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| License Number | 25607 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| CARR, KATHLEEN C | Agent |
| Name | Role |
|---|---|
| MENDOZA, VICTOR ESTRADA | Member |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
