| Name: | Southern Radiology Services, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 19 Dec 2001 (23 years ago) (Companies founded in December 2001) |
| Entity Number: | 000-603-946 |
| Register Number: | 000603946 |
| ZIP code: | 35147 (Companies in Shelby, 35147) |
| County: | Shelby |
| Place of Formation: | Louisiana |
| Principal Address: | 13505 N AMISS RDBATON ROUGE, LA 70810 |
| Registered Office Street Address: | 217 WOODBURY DRSTERRETT, AL 35147 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811988462 | 2005-11-02 | 2020-08-22 | 5545 SUPERIOR DR, BATON ROUGE, LA, 708168030, US | 300 CAHABA VALLEY CIR, PELHAM, AL, 351241148, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 225-293-3363 |
| Fax | 2252930245 |
| Phone | +1 800-845-8183 |
| Fax | 8003172757 |
Authorized person
| Name | MR. DONALD RAY POLLARD |
| Role | MANAGING MEMBER |
| Phone | 2252933363 |
Taxonomy
| Taxonomy Code | 335V00000X - Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
| State | MS |
| Is Primary | No |
| Taxonomy Code | 335V00000X - Portable X-ray and/or Other Portable Diagnostic Imaging Supplier |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 00126079 |
| State | MS |
| Name | Role |
|---|---|
| DONEGHE, MARY | Agent |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
