| Name: | J.W. Burns LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 05 Oct 2005 (19 years ago) |
| Entity Number: | 000-470-049 |
| Register Number: | 000470049 |
| County: | Madison |
| Place of Formation: | Madison County |
| Principal Address: | MADISON, AL |
| Registered Office Street Address: | 121B CASTLE DRMADISON, AL 35758 |
| Registered Office Street Address ZIP Code: | 35758 |
Activities
ANY LAWFUL ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164499398 | 2006-03-07 | 2008-07-29 | 121B CASTLE DR, MADISON, AL, 357588257, US | 121B CASTLE DR, MADISON, AL, 357588257, US | |||||||||||||||||||||||||
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| Phone | +1 256-489-7587 |
| Fax | 2564897588 |
Authorized person
| Name | MRS. WYKEEDA BURNS |
| Role | ADMINISTRATOR |
| Phone | 2564897857 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 683 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009937087 |
| State | AL |
| CAGE number | Status | Type | Established | CAGE Update Date | CAGE Expiration | SAM Expiration | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 49U23 | Obsolete | Non-Manufacturer | 2006-01-25 | 2023-07-09 | 2023-07-08 | No data | |||||||||||||||
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| POC | JOSEPH BURNS |
| Phone | +1 256-489-7587 |
| Fax | +1 256-489-7588 |
| Address | 121 CASTLE DRIVE SUITE B, MADISON, AL, 35758 8257, UNITED STATES |
Ownership of Offeror Information
| Highest Level Owner | Information not Available |
|---|
| Immediate Level Owner | Information not Available |
|---|
| List of Offerors (0) | Information not Available |
|---|
| Name | Role |
|---|---|
| BURNS, JOSEPH | Agent |
| Name | Role |
|---|---|
| BURNS, JOSEPH | Member |
| BURNS, WYKEEDA | Member |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
