| Name: | Monroeville Emergency Group, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 13 Dec 2002 (22 years ago) (Companies founded in December 2002) |
| Date of dissolution: | 23 Jan 2024 |
| Entity Number: | 000-686-555 |
| Register Number: | 000686555 |
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Registered Office Street Address: | 2 NORTH JACKSON ST., SUITE 605MONTGOMERY, AL 36104 |
Activities
ANY LAWFUL ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629090626 | 2006-07-25 | 2016-01-11 | 200 CORPORATE BLVD, LAFAYETTE, LA, 705083870, US | 2016 S ALABAMA AVE, MONROEVILLE, AL, 364603044, US | |||||||||||||||||||||||||||
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| Phone | +1 800-893-9698 |
Authorized person
| Name | LISHA FALK |
| Role | VP OF CONTRACTING |
| Phone | 8008939698 |
Taxonomy
| Taxonomy Code | 207P00000X - Emergency Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 363AM0700X - Medical Physician Assistant |
| Is Primary | No |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529925660 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| C T CORPORATION SYSTEM | Agent | 2 NORHT JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
| Name | Role |
|---|---|
| SCHUMACHER MEDICAL CORP OF ALABAMA | Member |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
