| Name: | Southern Ketamine and Wellness, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 24 Sep 2020 (4 years ago) |
| Entity Number: | 000-703-294 |
| Register Number: | 000703294 |
| County: | Shelby |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 1134 BRISTOL WAYBIRMINGHAM, AL 35242 |
| Registered Office Street Address ZIP Code: | 35242 |
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| E4NRQRG51UG4 | 2024-08-20 | 1932 LAUREL RD, IB, VESTAVIA, AL, 35216, 1859, USA | 1932 LAUREL ROAD, SUITE 1B, VESTAVIA, AL, 35216, 1859, USA | |||||||||||||||||||||||||||||||||||||||||
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| Congressional District | 06 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2023-09-01 |
| Initial Registration Date | 2022-12-28 |
| Entity Start Date | 2020-09-18 |
| Fiscal Year End Close Date | Dec 22 |
Service Classifications
| NAICS Codes | 621111, 621112, 621399, 621420, 621999 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | JOHN H IRONS |
| Role | DR. |
| Address | 1932 LAUREL ROAD, SUITE 1B, VESTAVIA, AL, 35216, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | JOHN H IRONS |
| Role | DR. |
| Address | 1932 LAUREL ROAD, SUITE 1B, VESTAVIA, AL, 35216, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700590007 | 2023-01-11 | 2023-03-15 | 1932 LAUREL RD STE 1B, VESTAVIA HILLS, AL, 352161939, US | 1932 LAUREL RD STE 1B, VESTAVIA HILLS, AL, 352161939, US | |||||||||||||||||||||||||
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| Phone | +1 205-202-9163 |
Authorized person
| Name | DR. JOHN HARRISON IRONS |
| Role | CO-OWNER |
| Phone | 2052029163 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | No |
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| Is Primary | Yes |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| Is Primary | No |
| Name | Role |
|---|---|
| RUNYANS, JOHN | Agent |
| Name | Role | Address |
|---|---|---|
| NELSON, MARY STEWART | Organizer | 400 CENTURY PARK SOUTH, #224BIRMINGHAM, AL 35226-5102 |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
