| Name: | N.E. Alabama Nephrology, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 03 Feb 2003 (22 years ago) (Companies founded in February 2003) |
| Entity Number: | 000-687-749 |
| Register Number: | 000687749 |
| ZIP code: | 35901 (Companies in Etowah, 35901) |
| County: | Etowah |
| Place of Formation: | Etowah County |
| Principal Address: | GADSDEN, AL |
| Registered Office Street Address: | 427 S 3RD STGADSDEN, AL 35901 |
Activities
MEDICINE PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730269119 | 2006-10-17 | 2008-06-17 | 425 S 3RD ST, GADSDEN, AL, 359015210, US | 425 S 3RD ST, GADSDEN, AL, 359015210, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 256-543-3508 |
Authorized person
| Name | DR. EDWARD F HWANG |
| Role | PHYSICIAN |
| Phone | 2565433508 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | 7691 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 174400000X - Specialist |
| License Number | 18372 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 174400000X - Specialist |
| License Number | 21162 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009916955 |
| State | AL |
| Issuer | GROUP |
| Number | J268 |
| State | AL |
| Issuer | MEDICAID |
| Number | 009917005 |
| State | AL |
| Issuer | MEDICAID |
| Number | 009916975 |
| State | AL |
| Name | Role |
|---|---|
| GHAFARY, ELIAS M | Agent |
| Name | Role |
|---|---|
| KWAN, GARY W | Member |
| HWANG, EDWARD | Member |
| GHAFARY, ELIAS M | Member |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
