| Name: | Enterprise Open MRI, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 14 Apr 2003 (22 years ago) (Companies founded in April 2003) |
| Entity Number: | 000-605-318 |
| Register Number: | 000605318 |
| ZIP code: | 36330 (Companies in Coffee, 36330) |
| County: | Coffee |
| Place of Formation: | Delaware |
| Principal Address: | 100 PROFESSIONAL LANE STE BENTERPRISE, AL 36330 |
| Registered Office Street Address: | 109 PROFESSIONAL LANE SUITE BENTERPRISE, AL 36330 |
Activities
DIAGNOSTIC IMAGING
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740204346 | 2006-07-27 | 2010-12-09 | 194 E. REDSTONE AVE. SUITE A, CRESTVIEW, FL, 325395348, US | 100 PROFESSIONAL LANE SUITE B, ENTERPRISE, AL, 36330, US | |||||||||||||||||||||||||||||
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| Phone | +1 334-684-7156 |
| Fax | 3346847709 |
| Phone | +1 334-308-1524 |
| Fax | 3343081528 |
Authorized person
| Name | JOHN C. TOMBERLIN |
| Role | OWNER |
| Phone | 3346847156 |
Taxonomy
| Taxonomy Code | 261QM1200X - Magnetic Resonance Imaging (MRI) Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS |
| Number | 051519465 |
| Issuer | MEDICAID |
| Number | 051554517 |
| State | AL |
| Name | Role |
|---|---|
| CADENHEAD, SUE | Agent |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
