| Name: | Childersburg Diagnostic Imaging, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 01 Jul 2004 (20 years ago) |
| Date of dissolution: | 20 Jan 2017 |
| Entity Number: | 000-453-441 |
| Register Number: | 000453441 |
| County: | Talladega |
| Place of Formation: | Talladega County |
| Principal Address: | CHILDERSBURG, AL |
| Registered Office Street Address: | 34011 HIGHWAY 280 ECHILDERSBURG, AL 35044 |
| Registered Office Street Address ZIP Code: | 35044 |
Activities
PROVIDE DIAGNOSTIC IMAGING SERVICES/OWN/OPERATE CENTER
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013195254 | 2008-02-08 | 2008-02-15 | PO BOX 349, CHILDERSBURG, AL, 350440349, US | 34011 US HIGHWAY 280, CHILDERSBURG, AL, 350442128, US | |||||||||||||||||
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| Phone | +1 256-378-3313 |
Authorized person
| Name | MICHAEL T BICE |
| Role | ADMINISTRATOR |
| Phone | 2563783313 |
Taxonomy
| Taxonomy Code | 293D00000X - Physiological Laboratory |
| License Number | 11948 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BICE, MICHAEL T | Member | No data |
| CONNOR, GORDON | Member | No data |
| MIRELMAN, SIMON | Member | 140 STAR TREK DRIVEPELHAM, AL 35124 |
| Name | Role |
|---|---|
| BICE, MCIHAEL T | Agent |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
