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Cullman Regional Nurse Anesthetists, LLC

Details

Name: Cullman Regional Nurse Anesthetists, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Dissolved
Date of registration: 19 Apr 2010 (15 years ago)
Date of dissolution: 30 Oct 2017
Entity Number: 000-446-099
Register Number: 000446099
County: Cullman
Place of Formation: Cullman County
Principal Address: VINEMONT, AL
Registered Office Street Address: 156 CO RD 1313VINEMONT, AL 35179
Registered Office Street Address ZIP Code: 35179

Activities COMPREHENSIVE ANESTHESIA CARE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1215334594 2014-12-02 2015-09-29 7956 VAUGHN RD # 165, MONTGOMERY, AL, 361166625, US 1912 AL HIGHWAY 157, CULLMAN, AL, 350580609, US

Contacts

Phone +1 888-316-7491
Fax 3342397654
Phone +1 256-737-2000

Authorized person

Name MR. NORMAN RAY BURKETT
Role PRESIDENT
Phone 3343966930

Taxonomy

Taxonomy Code 367500000X - Certified Registered Nurse Anesthetist
License Number 1-051912
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CRNA, LLC 401K PLAN 2015 383813077 2016-03-31 CULLMAN REGIONAL NURSE ANESTHETISTS, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-04-01
Business code 812990
Sponsor’s telephone number 2563397612
Plan sponsor’s address 1010 COUNTRY ROAD 1539, CULLMAN, AL, 35058

Agent

Name Role
BURKETT, NORMAN RAY Agent

Member

Name Role
BURKETT, NORMAN RAY Member

Date of last update: 13 Aug 2024

Sources: Alabama Secretary of State