| Name: | Fort Payne Urgent Care, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 26 Oct 2021 (3 years ago) (Companies founded in October 2021) |
| Entity Number: | 000-949-732 |
| Register Number: | 000949732 |
| Historical Names: |
Maximus Consulting Healthcare group LLC
|
| ZIP code: | 35967 (Companies in De Kalb, 35967) |
| County: | De Kalb |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 100 FOREST AVE NW, NoneFort Payne, AL 35967 |
| Registered Office Mailing Address: | 100 FOREST AVE NW, NoneFORT PAYNE, AL 35967 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1346986015 | 2022-05-06 | 2022-10-07 | 100 FOREST AVE NW, FORT PAYNE, AL, 359672054, US | 2605 GAULT AVE N STE 200, FORT PAYNE, AL, 359673700, US | |||||||||||||||||||||||||
|
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| Phone | +1 256-979-1990 |
| Fax | 2569791992 |
| Fax | 3569791992 |
Authorized person
| Name | LUIZ JUAN |
| Role | OWNER |
| Phone | 2569791990 |
Taxonomy
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 363LA2100X - Acute Care Nurse Practitioner |
| Is Primary | No |
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | No |
| Name | Role |
|---|---|
| Juan, Luiz | Agent |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2022-01-25 | Name Change | Maximus Consulting Healthcare group LLC | Fort Payne Urgent Care, LLC |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
