| Name: | Jasper Urgent Care, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 06 Jul 2006 (18 years ago) |
| Date of dissolution: | 10 Mar 2010 |
| Entity Number: | 000-481-098 |
| Register Number: | 000481098 |
| County: | Walker |
| Place of Formation: | Walker County |
| Principal Address: | JASPER, AL |
| Registered Office Street Address: | 120 NORTH WALSTON RDJASPER, AL 35504 |
| Registered Office Street Address ZIP Code: | 35504 |
Activities
PROVIDE MEDICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588686505 | 2006-07-25 | 2008-06-17 | 4330 78 EAST #115, MEDICAL PLAZA SUITE 115, JASPER, AL, 355018955, US | 4330 78 EAST #115, MEDICAL PLAZA EAST SUITE 115, JASPER, AL, 355018955, US | |||||||||||||||||||||
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| Phone | +1 205-295-0002 |
| Fax | 2052950991 |
Authorized person
| Name | BOLANLE O GBADEBO |
| Role | OWNER |
| Phone | 2052950002 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529929710 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| WEBSTER, BRUCE C | Agent | 1000 URBAN CENTER DRIVE #350BIRMINGHAM, AL 35242 |
| Name | Role |
|---|---|
| ENCOMPASS LLC | Member |
| STUKES, RICKIE L | Member |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
