| Name: | VIP Medical Services, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 19 Dec 2006 (18 years ago) |
| Date of dissolution: | 04 Jan 2017 |
| Entity Number: | 000-487-775 |
| Register Number: | 000487775 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 1012 IRVING RDHOMEWOOD, AL 35209 |
| Registered Office Street Address ZIP Code: | 35209 |
| Principal Address: | HOMEWOOD, AL |
Activities
ANY LAWFUL ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124271283 | 2008-11-02 | 2011-06-24 | 1012 IRVING RD, HOMEWOOD, AL, 352093428, US | 608 STONE AVENUE, TALLADEGA, AL, 356102217, US | |||||||||||||||||||
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| Phone | +1 205-427-0691 |
Authorized person
| Name | DR. RONALD M ROAN |
| Role | PRESIDENT |
| Phone | 2054270691 |
Taxonomy
| Taxonomy Code | 207LC0200X - Critical Care Medicine (Anesthesiology) Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 128722 |
| State | AL |
| Name | Role |
|---|---|
| ROAN, RONALD | Agent |
| Name | Role |
|---|---|
| ROAN, RONALD | Member |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
