| Name: | Albertville Family Medicine, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 10 May 2023 (2 years ago) |
| Entity Number: | 001-078-753 |
| Register Number: | 001078753 |
| County: | Madison |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 7522 Hadleigh Crest Dr. SEOwens Cross Roads, AL 35763 |
| Registered Office Street Address ZIP Code: | 35763 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154008480 | 2023-06-29 | 2023-10-25 | 201 W MAIN ST, ALBERTVILLE, AL, 359501627, US | 201 W MAIN ST, ALBERTVILLE, AL, 359501627, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 256-251-2012 |
| Fax | 2562512301 |
| Phone | +1 256-929-9074 |
Authorized person
| Name | MONICA HAGOOD |
| Role | REGISTERED NURSE |
| Phone | 2566771320 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| Hagood, Eric | Agent |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
