| Name: | Diabetes and Endocrine Wellness Center, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 28 Mar 2011 (14 years ago) |
| Entity Number: | 000-008-017 |
| Register Number: | 000008017 |
| ZIP code: | 35749 |
| County: | Madison |
| Place of Formation: | Madison County |
| Registered Office Street Address: | 110 BURWELL VALLEY LNHARVEST, AL 35749 |
Activities
MEDICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255623021 | 2011-05-11 | 2011-09-06 | PO BOX 16099, HUNTSVILLE, AL, 358021662, US | 1 HOSPITAL DR SW, SUITE 300, HUNTSVILLE, AL, 358016455, US | |||||||||||||||||||||||
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| Phone | +1 256-881-2700 |
| Fax | 8669669740 |
Authorized person
| Name | MR. DWAIN ERSKIN WOODE |
| Role | MD |
| Phone | 2568812700 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| Is Primary | Yes |
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| WOODE, DWAIN E | Organizer | 110 BURWELL VALLEY LNHARVEST, AL 35749 |
| WOODE, CHARMAINE BLAKE | Organizer | 110 BURWELL VALLEY LNHARVEST, AL 35749 |
| Name | Role |
|---|---|
| BLAKE, SHIRLEY | Agent |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
