| Name: | Physicians Credentialing Services, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 12 Dec 2023 (a year ago) (Companies founded in December 2023) |
| Entity Number: | 001-111-631 |
| Register Number: | 001111631 |
| ZIP code: | 35806 (Companies in Madison, 35806) |
| County: | Madison |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 1858 Shellbrook Dr. NWHuntsville, AL 35806 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619711918 | 2024-06-21 | 2024-06-21 | 2743 BOB WALLACE AVE SW STE D, HUNTSVILLE, AL, 358054103, US | 2743 BOB WALLACE AVE SW STE D, HUNTSVILLE, AL, 358054103, US | |||||||||||||||
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| Phone | +1 256-246-8634 |
| Fax | 2569377571 |
Authorized person
| Name | LEAH TISSUE |
| Role | OWNER |
| Phone | 2562468634 |
Taxonomy
| Taxonomy Code | 305S00000X - Point of Service |
| Is Primary | Yes |
| Name | Role |
|---|---|
| MARY L TISSUE | Agent |
Date of last update: 18 Aug 2024
Sources: Alabama Secretary of State
