| Name: | Decatur Health Imaging, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 31 Jan 2003 (22 years ago) |
| Entity Number: | 000-687-652 |
| Register Number: | 000687652 |
| Historical Names: |
Birmingham Health Imaging, L.L.C.
|
| County: | Montgomery |
| Place of Formation: | Cullman County |
| Registered Office Street Address: | 2 NORTH JACKSON STREET, SUITE 605MONTGOMERY, AL 36104 |
| Registered Office Street Address ZIP Code: | 36104 |
Activities
PROVIDE DIAGNOSTIC IMAGING SERVICES TO PATIENTS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508973017 | 2006-08-23 | 2021-01-19 | 18201 VON KARMAN AVE STE 600, IRVINE, CA, 926121176, US | 1123 16TH AVE SE, DECATUR, AL, 356013534, US | |||||||||||||||||||||||
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| Phone | +1 800-544-3215 |
| Phone | +1 256-350-6364 |
| Fax | 2563518436 |
Authorized person
| Name | WILLIAM LARKIN |
| Role | CFO |
| Phone | 8005443215 |
Taxonomy
| Taxonomy Code | 261QR0200X - Radiology Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529922450 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| C T CORPORATION SYSTEM | Agent | 2 NORHT JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
| Name | Role | Address |
|---|---|---|
| HEALTH IMAGING LLC | Member | No data |
| MOLECULAR IMAGING TECHNOLOGIES LLC | Member | 486 NORRISTOWN ROAD SUITE 133BLUE BELL, PA 19422 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2016-09-28 | Name Merged | No data | DECATUR PET, LLC |
| 2003-03-25 | Name Change | Birmingham Health Imaging, L.L.C. | Decatur Health Imaging, L.L.C. |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
