| Name: | Gulf Shores Emergency Physicians, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 10 Nov 2020 (4 years ago) |
| Entity Number: | 000-820-738 |
| Register Number: | 000820738 |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Registered Office Street Address: | 641 South Lawrence StreetMontgomery, AL 36104 |
| Registered Office Street Address ZIP Code: | 36104 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295339638 | 2020-11-25 | 2021-04-22 | 5665 NEW NORTHSIDE DR STE 320, ATLANTA, GA, 303285834, US | 3590 GULF SHORES PARKWAY, GULF SHORES, AL, 36542, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 770-874-5400 |
| Phone | +1 251-215-4853 |
Authorized person
| Name | KIM LARSEN |
| Role | DIRECTOR OF CREDENTIALING |
| Phone | 7708745400 |
Taxonomy
| Taxonomy Code | 207P00000X - Emergency Medicine Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| Corporation Service Company Inc. | Agent |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
