| Name: | Magic City Eyecare, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 04 May 2020 (5 years ago) (Companies founded in May 2020) |
| Entity Number: | 000-630-200 |
| Register Number: | 000630200 |
| ZIP code: | 35226 (Companies in Jefferson, 35226) |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 605 BELLE TERRE CIRCLEVESTAVIA, AL 35226 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497368211 | 2020-08-31 | 2020-10-22 | 9839 S 168TH AVE STE F, OMAHA, NE, 681361116, US | 8011 LIBERTY PKWY STE 103, VESTAVIA, AL, 352427670, US | |||||||||||||||||||||||
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| Phone | +1 402-504-4680 |
| Phone | +1 205-506-2200 |
| Fax | 2055062257 |
Authorized person
| Name | DR. KACEY C CILIMBERG |
| Role | OWNER |
| Phone | 2055062200 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 103I414821 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| CILIMBERG, KACEY C | Agent | 605 BELLE TERRE CIRCLEVESTAVIA, AL 35226 |
| Name | Role | Address |
|---|---|---|
| CILIMBERG, KACEY C | Organizer | 605 BELLE TERRE CIRCLEVESTAVIA, AL 35226 |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
