| Name: | Clarke County Internal Medicine, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 29 Jan 2007 (18 years ago) |
| Entity Number: | 000-612-350 |
| Register Number: | 000612350 |
| County: | Clarke |
| Place of Formation: | Georgia |
| Principal Address: | 33700 HWY 43THOMASVILLE, AL 36784 |
| Principal Address ZIP Code: | 36784 |
Activities
HOSPITAL & HEALTHCARE SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1518085695 | 2007-03-27 | 2020-08-22 | 411 WILSON AVE, THOMASVILLE, AL, 36784, US | 411 WILSON AVE, THOMASVILLE, AL, 36784, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 334-636-5696 |
| Fax | 3346360086 |
Authorized person
| Name | MR. KEVIN BIERSCHENC |
| Role | CEO SOUTHWEST ALABAMA MEDICAL |
| Phone | 3346364431 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| SIMS, LISA | Agent |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
