| Name: | Vaughan Regional Medical Center, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 08 Aug 2001 (23 years ago) |
| Entity Number: | 000-603-502 |
| Register Number: | 000603502 |
| County: | Montgomery |
| Place of Formation: | Delaware |
| Principal Address: | 330 SEVEN SPRINGS WAYBRENTWOOD, TN 37027 |
| Registered Office Street Address: | 2 NORTH JACKSON ST., SUITE 605MONTGOMERY, AL 36104 |
| Registered Office Street Address ZIP Code: | 36104 |
Activities
HOSPITAL & RELATED HEALTHCARE SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770600066 | 2007-03-23 | 2021-03-19 | 330 SEVEN SPRINGS WAY, BRENTWOOD, TN, 370275098, US | HIGHWAY 45 SOUTH, ROUTE 2, BOX 4-D, MARION, AL, 36756, US | |||||||||||||||||||||||
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| Phone | +1 615-920-7000 |
| Fax | 6159208913 |
| Phone | +1 334-683-9085 |
Authorized person
| Name | KATHY J TEAGUE |
| Role | ASSISTANT VICE PRESIDENT, SECRETARY |
| Phone | 6159207000 |
Taxonomy
| Taxonomy Code | 261QR1300X - Rural Health Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 540003982 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| C T CORPORATION SYSTEM | Agent | 2 NORHT JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DCA | AWARD | VA247P1025 | 2009-08-01 | 2010-07-31 | 2014-07-31 | |||||||||||||||||||||
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| Title | RADIOLOGY SERVICES |
| NAICS Code | 621512: DIAGNOSTIC IMAGING CENTERS |
| Product and Service Codes | Q522: RADIOLOGY SERVICES |
Recipient Details
| Recipient | VAUGHAN REGIONAL MEDICAL CENTER LLC |
| UEI | FNTDK7J7WKQ6 |
| Legacy DUNS | 030263052 |
| Recipient Address | UNITED STATES, 1015 MEDICAL CENTER PKWY, SELMA, 367016748 |
| Unique Award Key | CONT_AWD_VA247P1018_3600_-NONE-_-NONE- |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Description
| Title | LAB SERVICES |
| NAICS Code | 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS) |
| Product and Service Codes | Q301: LABORATORY TESTING SERVICES |
Recipient Details
| Recipient | VAUGHAN REGIONAL MEDICAL CENTER LLC |
| UEI | FNTDK7J7WKQ6 |
| Legacy DUNS | 030263052 |
| Recipient Address | UNITED STATES, 1015 MEDICAL CENTER PKWY, SELMA, 367016748 |
| Unique Award Key | CONT_AWD_VA679C95149_3600_-NONE-_-NONE- |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Description
| Title | SELMA OUTREACH CLINIC BUILD OUT |
| NAICS Code | 236220: COMMERCIAL AND INSTITUTIONAL BUILDING CONSTRUCTION |
| Product and Service Codes | Z141: MAINT-REP-ALT/HOSPITALS & INFIRMARY |
Recipient Details
| Recipient | VAUGHAN REGIONAL MEDICAL CENTER LLC |
| UEI | FNTDK7J7WKQ6 |
| Legacy DUNS | 030263052 |
| Recipient Address | UNITED STATES, 1015 MEDICAL CENTER PKWY, SELMA, 367016748 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
