| Name: | Carmichael Imaging, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 02 Apr 2002 (23 years ago) (Companies founded in April 2002) |
| Date of dissolution: | 29 Nov 2017 |
| Entity Number: | 000-681-372 |
| Register Number: | 000681372 |
| ZIP code: | 36106 (Companies in Montgomery, 36106) |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Principal Address: | MONTGOMERY, AL |
| Registered Office Street Address: | 4145 CARMICHAEL RDMONTGOMERY, AL 36106 |
Activities
OWN/OPERATE AN IMAGING CENTER
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497707111 | 2006-05-17 | 2008-10-17 | 4145 CARMICHAEL RD, MONTGOMERY, AL, 361062803, US | 4145 CARMICHAEL RD, MONTGOMERY, AL, 361062803, US | |||||||||||||||||||||
|
|||||||||||||||||||||||||
| Phone | +1 334-273-2320 |
| Fax | 3342732386 |
Authorized person
| Name | MR. VENTY BUTTS |
| Role | ADMINISTRATOR |
| Phone | 3343871100 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 051550934 |
| State | AL |
| Name | Role |
|---|---|
| BUTTS, VENTY W | Agent |
| Name | Role |
|---|---|
| MONTGOMERY CANCER CENTER LLC | Member |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PO | AWARD | DJBMONIVB210353 | 2009-04-01 | 2009-04-01 | 2009-04-01 | |||||||||||||||||||||
|
||||||||||||||||||||||||||
| Title | PATIENT SERVICES - INMATE REEVES. |
| NAICS Code | 621399: OFFICES OF ALL OTHER MISCELLANEOUS HEALTH PRACTITIONERS |
| Product and Service Codes | Q201: GENERAL HEALTH CARE SERVICES |
Recipient Details
| Recipient | CARMICHAEL IMAGING, LLC |
| UEI | F8QFN4AJ5DQ6 |
| Legacy DUNS | 160342213 |
| Recipient Address | UNITED STATES, 4147 CARMICHAEL ROAD, MONTGOMERY, 361062803 |
| Unique Award Key | CONT_AWD_DJBMONIVB210163_1540_-NONE-_-NONE- |
| Awarding Agency | Department of Justice |
| Link | View Page |
Description
| Title | MEDICAL SERVICES. |
| NAICS Code | 621512: DIAGNOSTIC IMAGING CENTERS |
| Product and Service Codes | Q201: GENERAL HEALTH CARE SERVICES |
Recipient Details
| Recipient | CARMICHAEL IMAGING, LLC |
| UEI | F8QFN4AJ5DQ6 |
| Legacy DUNS | 160342213 |
| Recipient Address | UNITED STATES, 4147 CARMICHAEL ROAD, MONTGOMERY, 361062803 |
| Unique Award Key | CONT_AWD_DJBMONB21HV0049_1540_-NONE-_-NONE- |
| Awarding Agency | Department of Justice |
| Link | View Page |
Description
| Title | MEDICAL SERVICES RECEIVED ON 11-06-2007. |
| NAICS Code | 621512: DIAGNOSTIC IMAGING CENTERS |
| Product and Service Codes | Q201: GENERAL HEALTH CARE SERVICES |
Recipient Details
| Recipient | CARMICHAEL IMAGING, LLC |
| UEI | F8QFN4AJ5DQ6 |
| Legacy DUNS | 160342213 |
| Recipient Address | UNITED STATES, 4147 CARMICHAEL ROAD, MONTGOMERY, 361062803 |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
