| Name: | Urgent Care Center, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 11 Oct 2002 (22 years ago) |
| Entity Number: | 000-685-348 |
| Register Number: | 000685348 |
| County: | Cullman |
| Place of Formation: | Cullman County |
| Principal Address: | CULLMAN, AL |
| Registered Office Street Address: | 104 THIRD ST SWCULLMAN, AL 35055 |
| Registered Office Street Address ZIP Code: | 35055 |
Activities
URGENT CARE MEDICAL FACILITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245274000 | 2006-06-15 | 2022-12-20 | PO BOX 870, CULLMAN, AL, 350560870, US | 1701 MAIN AVE SW, SUITE A, CULLMAN, AL, 350555250, US | |||||||||||||||||||||||||
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| Phone | +1 256-737-0880 |
Authorized person
| Name | THOMAS OLIVER |
| Role | DIRECTOR/OWNER |
| Phone | 2567370880 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RAILROAD MEDICARE |
| Number | CK5467 |
| State | AL |
| Issuer | MEDICAID |
| Number | 529913650 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| WILLIAMS, DAN | Member | 17037 BUFFALO RIDGE ROADNORTHPORT, AL 35475 |
| PEINHARDT, WILLIAM F | Member | 1890 ALABAMA HIGHWAY 157 SUITE 310CULLMAN, AL 35055 |
| HALL, MICHAEL | Member | 101 SEASCAPE DRIVE SUITE 101MIRAMAR BEACH, FL 32550 |
| MORRIS, JOHN D | Member | No data |
| HOLLAND, GARY E | Member | No data |
| OLIVER, THOMAS B | Member | No data |
| HOOVER, L JAMES | Member | 1890 AL HIGHWAY 157 SUITE 300CULLMAN, AL 35058 |
| LYRENE, GEORGE A | Member | No data |
| Name | Role | Address |
|---|---|---|
| WATERS, MICHAEL W | Agent | 101 1ST AVE NE SUITE 210CULLMAN, AL 35055 |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
