| Name: | Jemison Eye Care, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 29 Aug 2002 (22 years ago) (Companies founded in August 2002) |
| Date of dissolution: | 28 Dec 2015 |
| Entity Number: | 000-684-415 |
| Register Number: | 000684415 |
| ZIP code: | 35085 (Companies in Chilton, 35085) |
| County: | Chilton |
| Place of Formation: | Chilton County |
| Registered Office Street Address: | 24810 ALABAMA HWY 31JEMISON, AL 35085 |
| Registered Office Mailing Address: | PO BOX 730JEMISON, AL 35085 |
Activities
OPTOMETRY/ANY LAWFUL BUSINESS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1558403568 | 2007-02-13 | 2014-06-03 | PO BOX 730, JEMISON, AL, 350850730, US | 24810 US HIGHWAY 31, JEMISON, AL, 350857876, US | |||||||||||||||||||||||||||||
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| Phone | +1 205-688-1010 |
Authorized person
| Name | DR. LISA R GREEN |
| Role | CHAIRMAN OF BOARD OF DIRECTORS |
| Phone | 2056881010 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | S-A35-TA-588 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE PTAN |
| Number | 510G700150 |
| State | AL |
| Issuer | MEDICAID |
| Number | 529912640 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| GREEN, LISA | Agent | 24810 ALABAMA HIGHWAY 31JEMISON, AL 35085 |
| Name | Role | Address |
|---|---|---|
| GREEN, LISA | Member | 24810 ALABAMA HIGHWAY 31JEMISON, AL 35085 |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
