| Name: | Weiss Lake Hospitalists, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 25 Mar 2019 (6 years ago) |
| Entity Number: | 000-547-085 |
| Register Number: | 000547085 |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Registered Office Street Address: | 641 South Lawrence StreetMontgomery, AL 36104 |
| Registered Office Street Address ZIP Code: | 36104 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205397643 | 2019-03-28 | 2020-02-05 | PO BOX 24962, BELFAST, ME, 049152000, US | 400 NORTHWOOD DR, CENTRE, AL, 359601023, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 770-540-5400 |
| Phone | +1 256-927-5531 |
Authorized person
| Name | KIM H LARSEN |
| Role | DIRECTOR OF CREDENTIALING |
| Phone | 7708745400 |
Taxonomy
| Taxonomy Code | 208M00000X - Hospitalist Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| Corporation Service Company Inc. | Agent |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
