| Name: | Endocrinology & Diabetes Associates, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 21 Jul 1998 (26 years ago) |
| Date of dissolution: | 02 May 2024 |
| Entity Number: | 000-660-561 |
| Register Number: | 000660561 |
| County: | Madison |
| Place of Formation: | Madison County |
| Registered Office Street Address: | 201 SIVLEY RD STE 450HUNTSVILLE, AL 35801 |
| Registered Office Street Address ZIP Code: | 35801 |
Activities
PROFESSIONAL MEDICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932291747 | 2006-09-29 | 2010-02-19 | 201 SIVLEY RD SW, SUITE 450, HUNTSVILLE, AL, 358015134, US | 201 SIVLEY RD SW, SUITE 450, HUNTSVILLE, AL, 358015134, US | |||||||||||||||||||||
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| Phone | +1 256-551-4505 |
| Fax | 2565514474 |
Authorized person
| Name | MRS. KIM CHAMBERLAIN |
| Role | OFFICE MANAGER |
| Phone | 2565514505 |
Taxonomy
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529803210 |
| State | AL |
| Name | Role |
|---|---|
| JOHNSON, BOBBY N | Agent |
| Name | Role |
|---|---|
| JOHNSON, BOBBY N | Member |
| COWART, STEVEN L | Member |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
