| Name: | Limestone Community Care, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 21 Oct 2002 (22 years ago) |
| Date of dissolution: | 07 Sep 2021 |
| Entity Number: | 000-225-653 |
| Register Number: | 000225653 |
| ZIP code: | 35620 |
| County: | Limestone |
| Place of Formation: | Limestone County |
| Principal Address: | ELKMONT, AL |
| Registered Office Street Address: | 25565 LEVIE DAVIS DRELKMONT, AL 35620 |
| Authorized Capital: | $5,000 |
Activities
PHYSICIAN'S CLINIC
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023162856 | 2007-01-22 | 2012-05-02 | PO BOX 449, ELKMONT, AL, 356200449, US | 25442 AL HIGHWAY 127, ELKMONT, AL, 356200449, US | |||||||||||||||||||||||||||||||
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| Phone | +1 256-732-3712 |
| Fax | 2567323714 |
Authorized person
| Name | DR. WAYNE AUBREY JONES |
| Role | PRESIDENT |
| Phone | 2567323712 |
Taxonomy
| Taxonomy Code | 363LA2100X - Acute Care Nurse Practitioner |
| License Number | 19353 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529912810 |
| State | AL |
| Issuer | BCBS |
| Number | 51511593 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| CRAWFORD, JEFF | Agent | 608 E FORREST STREETATHENS, AL 35611 |
| Name | Role | Address |
|---|---|---|
| CRAWFORD, JEFF | Incorporator | 608 E FORREST STREETATHENS, AL 35611 |
| JONES, WAYNE | Incorporator | 5184 HIGHWAY 431 SOUTHBROWNSBORO, AL 35741 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
