| Name: | Druid City Physician Services, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 19 Feb 2021 (4 years ago) |
| Entity Number: | 000-836-320 |
| Register Number: | 000836320 |
| County: | Tuscaloosa |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 809 University Blvd. EastTuscaloosa, AL 35401 |
| Registered Office Street Address ZIP Code: | 35401 |
| Registered Office Mailing Address: | 1110 Dr. Edward Hillard DriveTuscaloosa, AL 35401 |
| Registered Office Mailing Address ZIP Code: | 35401 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356911564 | 2021-06-29 | 2021-06-29 | 3901 GREENSBORO AVE STE A, TUSCALOOSA, AL, 354053771, US | 701 UNIVERSITY BLVD E STE 807, TUSCALOOSA, AL, 354017479, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 205-333-4661 |
| Phone | +1 205-759-6873 |
Authorized person
| Name | MR. DANIEL CLAY CONVILLE |
| Role | CORP DIRECTOR, PHYSICIAN SERVICES |
| Phone | 2057596165 |
Taxonomy
| Taxonomy Code | 207VM0101X - Maternal & Fetal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Jones, Chris | Agent | 410 Saint Charles StreetBirmingham, AL 35209 |
| Name | Role | Address |
|---|---|---|
| SNOW, STEPHEN E | Organizer | 1201 GREENSBORO AVETUSCALOOSA, AL 35401 |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
