| Name: | Crestwood HB Medical Services, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 19 Jul 2023 (a year ago) |
| Entity Number: | 001-091-898 |
| Register Number: | 001091898 |
| County: | Montgomery |
| Place of Formation: | Delaware |
| Principal Address: | 4000 MERIDIAN BLVDFRANKLIN, TN 37067 |
| 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 | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548940497 | 2023-07-24 | 2024-01-24 | PO BOX 680060, FRANKLIN, TN, 370680060, US | 1 HOSPITAL DR SW, HUNTSVILLE, AL, 358016455, US | |||||||||||||||||||||||||||||
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| Phone | +1 615-628-6504 |
| Fax | 6156286877 |
| Phone | +1 256-429-4000 |
Authorized person
| Name | WENDI KEETON |
| Role | SR DIRECTOR, HOSPITAL BASED OPS |
| Phone | 8778929815 |
Taxonomy
| Taxonomy Code | 207P00000X - Emergency Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 208M00000X - Hospitalist Physician |
| Is Primary | No |
| Taxonomy Code | 363A00000X - Physician Assistant |
| Is Primary | No |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY INC | Agent | 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808 |
Date of last update: 18 Aug 2024
Sources: Alabama Secretary of State
