| Name: | Physicians Care of Gadsden, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 06 Jul 2004 (20 years ago) |
| Date of dissolution: | 19 Dec 2019 |
| Entity Number: | 000-453-253 |
| Register Number: | 000453253 |
| Historical Names: |
Physicians Urgent Care & Family Medicine, L.L.C.
|
| County: | Etowah |
| Place of Formation: | Etowah County |
| Registered Office Street Address: | 1039 FORREST AVEGADSDEN, AL 35901 |
| Registered Office Street Address ZIP Code: | 35901 |
Activities
MEDICINE PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457536161 | 2008-01-02 | 2018-09-19 | 1024 1ST AVE, GADSDEN, AL, 359013544, US | 1024 1ST AVE, GADSDEN, AL, 359013544, US | |||||||||||||||||||||||
|
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| Phone | +1 256-543-7406 |
| Fax | 2565437413 |
| Fax | 2565431661 |
Authorized person
| Name | DR. FREDERICK WAYNE KELLY |
| Role | PRESIDENT |
| Phone | 2565437406 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RAILROAD MEDICARE |
| Number | P00147324 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| KELLY, FREDERICK WAYNE | Member | 1039 FORREST AVENUEGADSDEN, AL 35901 |
| Name | Role |
|---|---|
| KELLY, FREDERICK WAY | Agent |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2018-06-07 | Name Change | Physicians Urgent Care & Family Medicine, L.L.C. | Physicians Care of Gadsden, LLC |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
