| Name: | Smith Lake Family Care, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 19 Jun 2020 (4 years ago) (Companies founded in June 2020) |
| Entity Number: | 000-635-958 |
| Register Number: | 000635958 |
| ZIP code: | 35148 (Companies in Walker, 35148) |
| County: | Walker |
| Place of Formation: | Walker County |
| Registered Office Mailing Address: | PO BOX 1289SUMITON, AL 35148 |
| Registered Office Street Address: | 312 OAK DRIVESUMITON, AL 35148 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306447776 | 2020-11-03 | 2020-11-04 | 6610 CURRY HWY, JASPER, AL, 355035664, US | 6610 CURRY HWY, JASPER, AL, 355035664, US | |||||||||||||||
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| Phone | +1 205-878-4800 |
| Fax | 2054717009 |
Authorized person
| Name | MICHELLE HAWTHORNE |
| Role | CREDENTIALING AND BILLING MANAGER |
| Phone | 2052922428 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | No |
| Name | Role |
|---|---|
| TERRIE A. SADBERRY | Agent |
| Name | Role | Address |
|---|---|---|
| MUMMEY, AUTUMN N | Organizer | 335 CLAYTON ROADJASPER, AL 35504 |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
