| Name: | Birmingham Surgery Center, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 15 Oct 2004 (20 years ago) (Companies founded in October 2004) |
| Entity Number: | 000-607-327 |
| Register Number: | 000607327 |
| Historical Names: |
Birmingham Endoscopy Center, LLC
|
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Delaware |
| Principal Address: | 310 SEVEN SPRINGS WAY STE 500BRENTWOOD, TN 37027 |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
Activities
TO OWN & OPERATE AN ENDOSCOPY CENTER IN BIRMINGHAM AL
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790756237 | 2006-02-01 | 2023-02-12 | 2621 19TH ST S, BIRMINGHAM, AL, 352091913, US | 2621 19TH ST S, BIRMINGHAM, AL, 352091913, US | |||||||||||||||||||||||||||||||
|
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| Phone | +1 205-271-8200 |
| Fax | 2052718332 |
Authorized person
| Name | JENNIFER BOYD BALDOCK |
| Role | OFFICER AND AUTHORIZED OFFICIAL |
| Phone | 6152345954 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| License Number | 09986 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | ASC0079C |
| State | AL |
| Issuer | MEDICAID |
| Number | 000029229 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY INC | Agent | 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2005-03-24 | Name Change | Birmingham Endoscopy Center, LLC | Birmingham Surgery Center, LLC |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
