Name: | Alabama Digestive Health Endoscopy Center L.L.C. |
Jurisdiction: | Alabama |
Legal type: | Domestic Limited Liability Company |
Status: | Exists |
Date of registration: | 14 Jun 2004 (20 years ago) |
Entity Number: | 000-452-358 |
Register Number: | 000452358 |
County: | Montgomery |
Place of Formation: | Montgomery County |
Registered Office Street Address: | 2 NORTH JACKSON STREET, SUITE 605MONTGOMERY, AL 36104 |
Registered Office Street Address ZIP Code: | 36104 |
Activities
ENDOSCOPY/AMBULATORY SURGERY CENTER
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1538758297 | 2021-01-15 | 2021-01-15 | 2018 BROOKWOOD MEDICAL CTR DR, BIRMINGHAM, AL, 352096898, US | 2018 BROOKWOOD MEDICAL CTR DR, BIRMINGHAM, AL, 352096898, US | |||||||||||||||||||
|
Phone | +1 205-877-1187 |
Authorized person
Name | TARA SHEA |
Role | ADMINISTRATOR |
Phone | 2058771114 |
Taxonomy
Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
Is Primary | Yes |
Other Provider Identifiers
Issuer | BLUE CROSS BLUE SHIELD |
Number | 011072 |
State | AL |
Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
ADHEC 401(K) PLAN | 2009 | 201243484 | 2010-09-16 | ALABAMA DIGESTIVE HEALTH ENDOSCOPY CENTER | 13 | |||||||||||||||||||||||||||||
|
Administrator’s EIN | 201243484 |
Plan administrator’s name | ALABAMA DIGESTIVE HEALTH ENDOSCOPY CENTER |
Plan administrator’s address | 2010 BROOKWOOD MEDICAL CENTER DR, BIRMINGHAM, AL, 35209 |
Administrator’s telephone number | 2058246250 |
Signature of
Role | Plan administrator |
Date | 2010-09-16 |
Name of individual signing | MIKE RICKMAN |
Name | Role | Address |
---|---|---|
CT CORPORATION SYSTEM | Agent | 6190 POWERS FERRY RD STE 600ATLANTA, GA 30339 |
Name | Role | Address |
---|---|---|
DICKINSON, DOUGLAS S | Member | 2020 LAKE HEATHER DRIVEBIRMINGHAM, AL 35242 |
LANDY, DAVID | Member | No data |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State