| Name: | Beaverton Family Medicine LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 22 Mar 2023 (2 years ago) (Companies founded in March 2023) |
| Entity Number: | 001-070-299 |
| Register Number: | 001070299 |
| ZIP code: | 35802 (Companies in Madison, 35802) |
| County: | Madison |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 600 Boulevard South SW Suite 104JHuntsville, AL 35802 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578240511 | 2023-06-30 | 2023-07-14 | 12815 HIGHWAY 278, BEAVERTON, AL, 355442954, US | 12815 HIGHWAY 278, BEAVERTON, AL, 355442954, US | |||||||||||||
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| Phone | +1 205-606-1200 |
Authorized person
| Name | MICHAEL ETHAN BUTLER |
| Role | PRACTICE MANAGER |
| Phone | 2565904137 |
Taxonomy
| Taxonomy Code | 363LF0000X - Family Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| United States Corporation Agents, Inc. | Agent | 101 N Brand Blvd. 11th FloorGlendale, CA 91203 |
| Name | Role | Address |
|---|---|---|
| Legalzoom.com, Inc. | Organizer | 101 N Brand Blvd., 11th FlGlendale, CA 91203 |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
