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Cutaneous Oncology & Surgery Center, LLC

Details

Name: Cutaneous Oncology & Surgery Center, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 27 Sep 2011 (13 years ago)
Entity Number: 000-026-194
Register Number: 000026194
ZIP code: 35242
County: Shelby
Place of Formation: Jefferson County
Registered Office Street Address: 2000 STONEGATE TRAIL SUITE 12BIRMINGHAM, AL 35242

Activities SURGERY CENTER

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1699139915 2016-04-12 2020-03-04 1940 STONEGATE DR STE 140, VESTAVIA HLS, AL, 352422541, US 1940 STONEGATE DR STE 140, VESTAVIA HLS, AL, 352422541, US

Contacts

Phone +1 205-968-3919
Fax 2059683918

Authorized person

Name DR. CHRISTOPHER HARMON
Role OWNER
Phone 2059779876

Taxonomy

Taxonomy Code 261QA1903X - Ambulatory Surgical Clinic/Center
State AL
Is Primary Yes

Other Provider Identifiers

Issuer BLUE CROSS BLUE SHIELD OF ALABAMA
Number 014-348
State AL
Issuer CMS CCN
Number 01C0001056
State AL
Issuer STATE LICENSE
Number U3714
State AL

Agent

Name Role Address
HARMON, CHRISTOPHER B Agent 33 INVERNESS CENTER PARKWAYBIRMINGHAM, AL 35242

Organizer

Name Role Address
HARMON, CHRISTOPHER B Organizer 33 INVERNESS CENTER PARKWAYBIRMINGHAM, AL 35242
LEVY, JACK B Organizer 1819 FIFTH AVENUE NBIRMINGHAM, AL 35203

Date of last update: 30 Jul 2024

Sources: Alabama Secretary of State