| Name: | PRESTIGE TELEMEDICINE GROUP, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 20 Apr 2020 (5 years ago) |
| Entity Number: | 000-628-238 |
| Register Number: | 000628238 |
| County: | Baldwin |
| Place of Formation: | Baldwin County |
| Registered Office Street Address: | 1008 Randall AveDaphne, AL 36526 |
| Registered Office Street Address ZIP Code: | 36526 |
| Registered Office Mailing Address: | P.O. Box 222Montrose, AL 36559 |
| Registered Office Mailing Address ZIP Code: | 36559 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093324287 | 2020-07-23 | 2020-07-23 | 1008 RANDALL AVE, DAPHNE, AL, 365264231, US | 303 CUMBERLAND RD, FAIRHOPE, AL, 365323442, US | |||||||||||||
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| Phone | +1 251-517-4411 |
Authorized person
| Name | LAUREN BROOKS FAGGARD |
| Role | GENERAL MANAGER |
| Phone | 2516104188 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| Arnold, Lisa | Agent |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
