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Greenhill Family Clinic, LLC

Details

Name: Greenhill Family Clinic, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 19 Jan 2007 (18 years ago) (Companies founded in January 2007)
Entity Number: 000-488-970
Register Number: 000488970
ZIP code: 35645 (Companies in Lauderdale, 35645)
County: Lauderdale
Place of Formation: Lauderdale County
Principal Address: KILLEN, AL
Registered Office Street Address: 131 HWY 64KILLEN, AL 35645

Activities PROFESSIONAL MEDICAL SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1639234982 2006-12-27 2013-06-11 351 HIGHWAY 64, KILLEN, AL, 35645, US 351 HIGHWAY 64, KILLEN, AL, 35645, US

Contacts

Phone +1 256-272-8066
Fax 2562728375

Authorized person

Name DR. STEVE E WAMPLER
Role PRESIDENT
Phone 2562728066

Taxonomy

Taxonomy Code 207Q00000X - Family Medicine Physician
Is Primary Yes
Taxonomy Code 261QE0002X - Emergency Care Clinic/Center
Is Primary No

Other Provider Identifiers

Issuer MEDICARE RAILROAD
Number DF5641
State SC
Issuer MEDICAID
Number 529931670
State AL
Issuer DEPARTMENT OF LABOR
Number 612248600
State FL

Agent

Name Role
WAMPLER, STEVE M Agent

Member

Name Role
WAMPLER, STEVE M Member

Date of last update: 14 Aug 2024

Sources: Alabama Secretary of State