| Name: | Open MRI of Auburn Opelika, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 21 Mar 2006 (19 years ago) (Companies founded in March 2006) |
| Date of dissolution: | 18 Jan 2018 |
| Entity Number: | 000-476-529 |
| Register Number: | 000476529 |
| ZIP code: | 35801 (Companies in Madison, 35801) |
| County: | Madison |
| Place of Formation: | Madison County |
| Principal Address: | HUNTSVILLE, AL |
| Registered Office Street Address: | 604B MADISON STHUNTSVILLE, AL 35801 |
Activities
DIAGNOSTIC IMAGING SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851408512 | 2006-08-25 | 2008-02-22 | PO BOX 18006, HUNTSVILLE, AL, 358048006, US | 1441 GATEWAY DR, SUITE 1, OPELIKA, AL, 368015462, US | |||||||||||||||||||||
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| Phone | +1 256-533-2311 |
| Fax | 2565332231 |
Authorized person
| Name | TOMMY R HARRIS |
| Role | MANAGING MEMBER CEO |
| Phone | 2565332311 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE RR PALMETTO GBA |
| Number | P00359806 |
| State | AL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OPEN MRI OF AUBURN OPELIKA 401K PLAN | 2009 | 204540033 | 2010-10-15 | OPEN MRI OF AUBURN OPELIKA | 4 | |||||||||||||||||||||||||||||
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| Administrator’s EIN | 204540033 |
| Plan administrator’s name | OPEN MRI OF AUBURN OPELIKA |
| Plan administrator’s address | 1441 GATEWAY DR SUITE 1, OPELIKA, AL, 368015680 |
| Administrator’s telephone number | 2565333200 |
Signature of
| Role | Plan administrator |
| Date | 2010-10-15 |
| Name of individual signing | TOMMY HARRIS |
| Name | Role | Address |
|---|---|---|
| CHIVUKULA, KISHORE | Member | 1399 TURN LAKE DRIVEAUBURN, AL 36830 |
| LEGACY IMAGING LLC | Member | No data |
| GUM TREE INVESTMENTS INC | Member | No data |
| FULLER, KEITH L | Member | No data |
| GODSIL, RAYMOND D | Member | No data |
| LYLE, JAMES E | Member | No data |
| PATEL, HIREN K | Member | 106 HWY 82 BYPASS EASTPRATVILLE, AL 36067 |
| Name | Role |
|---|---|
| HARRIS, TOMMY R | Agent |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
