| Name: | Open MRI of Sylacauga, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 30 Aug 2004 (20 years ago) (Companies founded in August 2004) |
| Date of dissolution: | 05 Jun 2013 |
| Entity Number: | 000-454-803 |
| Register Number: | 000454803 |
| ZIP code: | 35242 (Companies in Shelby, 35242) |
| County: | Shelby |
| Place of Formation: | Shelby County |
| Principal Address: | HOOVER, AL |
| Registered Office Street Address: | 7500 HUGH DANEIL DR STE 110HOOVER, AL 35242 |
Activities
OWN/OPERATE EQUIPMENT/PROVIDE IMAGING SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1417928409 | 2006-01-30 | 2009-02-17 | PO BOX 933108, ATLANTA, GA, 311933108, US | 395 JAMES PAYTON BLVD, SYLACAUGA, AL, 351508064, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 205-995-9899 |
| Fax | 2059951255 |
| Phone | +1 256-207-2686 |
| Fax | 2562072551 |
Authorized person
| Name | MRS. CONNIE MARTIN |
| Role | DIRECTOR OF BILLING |
| Phone | 2059959388 |
Taxonomy
| Taxonomy Code | 261QM1200X - Magnetic Resonance Imaging (MRI) Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RUTH SNOW, MD |
| Number | 1124000344 |
| Issuer | CECIL EILAND, MD |
| Number | 1235111451 |
| Issuer | RAILROAD MEDICARE |
| Number | P00206200 |
| State | GA |
| Issuer | ROBERT EICHELBERGER, MD |
| Number | 1427030642 |
| Issuer | MARK CONNELL, MD |
| Number | 1730146069 |
| Issuer | MEDICAID |
| Number | 529925390 |
| State | AL |
| Issuer | N. MELINDA BERGQUIST, MD |
| Number | 1023040409 |
| State | AL |
| Issuer | THOMAS HARRELL, MD |
| Number | 1598747719 |
| Issuer | BCBS - FACILITY PROVIDER ID NUMBER |
| Number | 51530056 |
| State | AL |
| Issuer | DONALD REYNOLDS, MD |
| Number | 1659353886 |
| Issuer | PAMELA KULBACK, MD |
| Number | 1942282173 |
| Name | Role |
|---|---|
| COTE, PAUL | Agent |
| Name | Role |
|---|---|
| CYPRESS PARTNERS LLC | Member |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
