| Name: | Southeast Joint Replacement, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 18 Jan 2018 (7 years ago) |
| Entity Number: | 000-507-023 |
| Register Number: | 000507023 |
| County: | Houston |
| Place of Formation: | Houston County |
| Registered Office Street Address: | 212 WEST TROY STREET SUITE BDOTHAN, AL 36303 |
| Registered Office Street Address ZIP Code: | 36303 |
Activities
PROVIDE MEDICAL TREATMENT:JOINT REPLACEMENT
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578249868 | 2023-06-22 | 2023-06-22 | 2304 DE LEON AVE, MOBILE, AL, 366073212, US | 1720 SPRING HILL AVE FL 3, MOBILE, AL, 366041410, US | |||||||||||||||||||||
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| Phone | +1 251-654-3798 |
| Phone | +1 251-435-2663 |
Authorized person
| Name | DR. GRANT ZARZOUR |
| Role | PRESIDENT |
| Phone | 2516543798 |
Taxonomy
| Taxonomy Code | 171M00000X - Case Manager/Care Coordinator |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | INDIVIDUAL |
| Number | 1235424896 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| REGISTERED AGENTS INC | Agent | 212 W. TROY ST. STE BDOTHAN, AL 36303 |
| Name | Role | Address |
|---|---|---|
| ZARZOUR, GRANT | Member | 2304 DE LEON AVENUEMOBILE, AL 36607 |
| GRANBERRY, MICHAEL L | Member | 120 MCGREGOR AVENUE SOUTHMOBILE, AL 36608 |
| Name | Role | Address |
|---|---|---|
| ZARZOUR, GRANT | Organizer | 2304 DE LEON AVENUEMOBILE, AL 36607 |
| GRANBERRY, MICHAEL L | Organizer | 120 MCGREGOR AVENUE SOUTHMOBILE, AL 36608 |
| ZARZOUR, BREANNE S | Organizer | 101 DAUPHIN STREET SUITE 101MOBILE, AL 36602 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
