| Name: | RENEW Consulting Services, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 27 Apr 2020 (5 years ago) |
| Entity Number: | 000-629-792 |
| Register Number: | 000629792 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Registered Office Street Address: | 4416 PLUMTREE LANETUSCALOOSA, AL 35405 |
| Registered Office Street Address ZIP Code: | 35405 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265014344 | 2021-04-27 | 2021-04-27 | 5717 BRADFORD LN, TUSCALOOSA, AL, 354055680, US | 5717 BRADFORD LN, TUSCALOOSA, AL, 354055680, US | |||||||||||||||||||||||
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| Phone | +1 205-535-0325 |
| Fax | 2055757207 |
| Fax | 2055750683 |
Authorized person
| Name | KAREN STACY MOORE |
| Role | OWNER |
| Phone | 2055350325 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 156901 |
| State | AL |
| Name | Role |
|---|---|
| DIXON, JESSE | Agent |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
