| Name: | Dry Eye Center of Alabama, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 10 Jun 2020 (4 years ago) |
| Entity Number: | 000-634-578 |
| Register Number: | 000634578 |
| County: | Shelby |
| Place of Formation: | Shelby County |
| Registered Office Street Address: | 6000 RIDGE TRAILBIRMINGHAM, AL 35242 |
| Registered Office Street Address ZIP Code: | 35242 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134717572 | 2020-12-31 | 2020-12-31 | 3490 INDEPENDENCE DR STE 110, BIRMINGHAM, AL, 352095604, US | 3490 INDEPENDENCE DR STE 110, BIRMINGHAM, AL, 352095604, US | |||||||||||||||||||||
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| Phone | +1 205-490-2322 |
| Fax | 2055109469 |
Authorized person
| Name | DR. CHARLES DERRICK FRANKLIN |
| Role | PRACTICING OWNER |
| Phone | 2054902322 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 216124 |
| State | AL |
| Name | Role |
|---|---|
| FRANKLIN, CHARLES D | Agent |
| Name | Role | Address |
|---|---|---|
| CUNNINGHAM, RUSSELL M IV | Organizer | 2100 1ST AVENUE NORTH, SUITE 600BIRMINGHAM, AL 35203-9273 |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
