| Name: | Liberty Pediatrics LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Series Limited Liability Company |
| Status: | Exists |
| Date of registration: | 29 Jan 2018 (7 years ago) |
| Entity Number: | 000-508-186 |
| Register Number: | 000508186 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | 3748 DOVER DRMOUNTAIN BROOK, AL 35223 |
| Principal Address ZIP Code: | 35223 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629569744 | 2018-05-24 | 2018-05-24 | 4387 BOULDER LAKE CIR, VESTAVIA, AL, 352422116, US | 3735 CORPORATE WOODS DR STE 105, VESTAVIA, AL, 352422296, US | |||||||||||||
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| Phone | +1 205-492-0126 |
Authorized person
| Name | MR. CAMERON C DESHAZO |
| Role | OWNER/MANAGER |
| Phone | 2054920126 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| PURVI SHAH | Agent |
| Name | Role | Address |
|---|---|---|
| WILLOUGHBY, ANTHONY C ESQ. | Organizer | 1130 22ND STREET SOUTH SUITE 4000BIRMINGHAM, AL 35205 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
