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Maynor & Mitchell Optical Shop, LLC

Details

Name: Maynor & Mitchell Optical Shop, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 20 Aug 2002 (22 years ago)
Entity Number: 000-684-156
Register Number: 000684156
County: Madison
Place of Formation: Madison County
Registered Office Street Address: 3501 SOUTH MEMORIAL PKWYHUNTSVILLE, AL 35801
Registered Office Street Address ZIP Code: 35801
Principal Address: HUNTSVILLE, AL

Activities SELL EYEGLASSES & RELATED EYE WEAR

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1578589107 2006-07-15 2014-05-28 3501 MEMORIAL PKWY SW STE 200, HUNTSVILLE, AL, 358016901, US 3501 MEMORIAL PKWY SW STE 200, HUNTSVILLE, AL, 358016901, US

Contacts

Phone +1 256-533-0315
Fax 2565360360

Authorized person

Name WILLIAM N MITCHELL
Role OWNER
Phone 2565330315

Taxonomy

Taxonomy Code 332H00000X - Eyewear Supplier
State AL
Is Primary Yes
Taxonomy Code 332H00000X - Eyewear Supplier
License Number MD21789
State AL
Is Primary No

Other Provider Identifiers

Issuer BCBS PROVIDER NUMBER
Number 51511477
State AL
Issuer MEDICAID
Number 529916870
State AL

Agent

Name Role
MITCHELL, WILLIAM N Agent

Member

Name Role Address
MAYNOR, ROBERT C JR Member 300 BERRY HOLLOW RDGURLEY, AL 35748
MITCHELL, WILLIAM N Member No data

Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State