| Name: | Southeast Imaging Partners, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 01 Dec 2003 (21 years ago) (Companies founded in December 2003) |
| Date of dissolution: | 04 Aug 2009 |
| Entity Number: | 000-695-318 |
| Register Number: | 000695318 |
| ZIP code: | 35504 (Companies in Walker, 35504) |
| County: | Walker |
| Place of Formation: | Walker County |
| Principal Address: | JASPER, AL |
| Registered Office Street Address: | 120 N WALSTON BRIDGE RDJASPER, AL 35504 |
Activities
OWN/OPERATE MEDICAL EQUIPMENT
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538244439 | 2006-10-26 | 2007-07-12 | PO BOX 402, JASPER, AL, 35502, US | 1405 VALLEY RD, JASPER, AL, 355014932, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 205-221-3352 |
| Fax | 2052213352 |
Authorized person
| Name | MR. RICK L STUKES |
| Role | MANAGING PARTNER |
| Phone | 2052213352 |
Taxonomy
| Taxonomy Code | 171W00000X - Contractor |
| License Number | 11954 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 0515555049 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| WEBSTER, BRUCE C | Agent | 1000 URBAN CENTER DRIVE #350BIRMINGHAM, AL 35242 |
| Name | Role |
|---|---|
| ENCOMPASS LLC | Member |
| STUKES, RICKIE L | Member |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
