| Name: | Neurology-Neurodiagnostic Lab, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 30 Jan 2002 (23 years ago) (Companies founded in January 2002) |
| Entity Number: | 000-680-261 |
| Register Number: | 000680261 |
| ZIP code: | 35007 (Companies in Shelby, 35007) |
| County: | Shelby |
| Place of Formation: | Shelby County |
| Principal Address: | ALABASTER, AL |
| Registered Office Street Address: | 1004 1ST ST NORTH STE 330ALABASTER, AL 35007 |
Activities
MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417165127 | 2007-05-18 | 2008-10-01 | 1004 1ST ST N, SUITE330, ALABASTER, AL, 350078766, US | 1004 1ST ST N, SUITE330, ALABASTER, AL, 350078766, US | |||||||||||||||||||||||||
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| Phone | +1 205-664-2967 |
| Fax | 2056649689 |
Authorized person
| Name | DR. NASROLLAH ESLAMI |
| Role | OFFICE MANAGER |
| Phone | 2056642967 |
Taxonomy
| Taxonomy Code | 2084N0400X - Neurology Physician |
| License Number | 9098 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529918500 |
| State | AL |
| Name | Role |
|---|---|
| ESLAMI, NASROLLAH | Agent |
| Name | Role |
|---|---|
| ESLAMI, NASROLLAH | Member |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
