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EVI Physician Services I, LLC

Details

Name: EVI Physician Services I, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Dissolved
Date of registration: 31 Jul 2007 (17 years ago)
Date of dissolution: 28 Sep 2012
Entity Number: 000-498-128
Register Number: 000498128
County: Jefferson
Place of Formation: Jefferson County
Registered Office Street Address: 810 ST VINCENT'S DR POB I 3RD FLBIRMINGHAM, AL 35205
Registered Office Street Address ZIP Code: 35205
Principal Address: BIRMNGHAM, AL

Activities MEDICAL PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1740458967 2008-02-11 2009-08-28 810 SAINT VINCENTS DR, BIRMINGHAM, AL, 352051601, US 150 GILBREATH DR, ONEONTA, AL, 351212827, US

Contacts

Phone +1 205-989-4833
Fax 2058383102
Phone +1 205-274-3010
Fax 2052743002

Authorized person

Name MRS. SUSAN CORNEJO
Role CORPORATE CONTROLLER
Phone 2058383718

Taxonomy

Taxonomy Code 208M00000X - Hospitalist Physician
Is Primary Yes

Agent

Name Role
O'NEIL, JOHN D Agent

Member

Name Role
EASTSIDE VENTURES INC Member

Date of last update: 14 Aug 2024

Sources: Alabama Secretary of State