| Name: | Dekalb Radiologist Group, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 20 Nov 2006 (18 years ago) |
| Date of dissolution: | 03 Jan 2023 |
| Entity Number: | 000-487-027 |
| Register Number: | 000487027 |
| County: | De Kalb |
| Place of Formation: | DeKalb County |
| Principal Address: | FORT PAYNE, AL |
| Registered Office Street Address: | 200 MEDICAL CENTER DRFORT PAYNE, AL 35968 |
| Registered Office Street Address ZIP Code: | 35968 |
Activities
ANY LAWFUL ACTIVITY
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| VMSND3ARZFH4 | 2021-11-18 | 200 MEDICAL CENTER DR SW, FORT PAYNE, AL, 35968, USA | P.O. BOX 11407, BIRMINGHAM, AL, 35246, 2605, USA | |||||||||||||||||||||||||||||||||||||||||
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| Congressional District | 04 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2020-11-19 |
| Initial Registration Date | 2020-11-05 |
| Entity Start Date | 2015-07-01 |
| Fiscal Year End Close Date | Dec 31 |
Service Classifications
| NAICS Codes | 621512 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | SHASTA PRICE |
| Role | MEDICAL BILLING TECHNICIAN |
| Address | PO BOX 11407, BIRMINGHAM, AL, 35246, 2605, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | SHASTA PRICE |
| Role | MEDICAL BILLING TECHNICIAN |
| Address | PO BOX 11407, BIRMINGHAM, AL, 35246, 2605, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891848784 | 2007-01-22 | 2020-08-22 | PO BOX 680949, FORT PAYNE, AL, 359681610, US | 200 MEDICAL CENTER DRIVE, FORT PAYNE, AL, 35968, US | |||||||||||||||
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| Phone | +1 256-997-2189 |
| Fax | 2566387445 |
Authorized person
| Name | BRADLEY M COCKRAN |
| Role | OWNER |
| Phone | 2569972189 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| COCHRAN, BRADLEY | Agent |
| Name | Role |
|---|---|
| COCHRAN, BRADLEY | Member |
| MILLS, ROBERT C | Member |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
