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Camellia Imaging, LLC

Details

Name: Camellia Imaging, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 09 Dec 2015 (9 years ago)
Entity Number: 000-351-469
Register Number: 000351469
ZIP code: 35124
County: Shelby
Place of Formation: Shelby County
Registered Office Street Address: 251 OAK VIEW DRIVEINDIAN SPRINGS, AL 35124

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1316495997 2016-09-13 2017-01-18 2068 VALLEYDALE RD, HOOVER, AL, 352442092, US 2068 VALLEYDALE RD, HOOVER, AL, 352442092, US

Contacts

Phone +1 205-544-2828
Fax 2057831208
Fax 2052670192

Authorized person

Name MONIKA TATARIA
Role PRESIDENT
Phone 2055442828

Taxonomy

Taxonomy Code 2085R0202X - Diagnostic Radiology Physician
License Number MD.30928
State AL
Is Primary Yes

Other Provider Identifiers

Issuer INDIVIDUAL NPI
Number 1750597670

Agent

Name Role Address
COOPER, ROBERT Agent 3590 B PELHAM PKWY #164PELHAM, AL 35124

Organizer

Name Role Address
MCWILLIAMS, VAUGHN Organizer 2805 2ND AVENUE SOUTH STE 200BIRMINGHAM, AL 35233-4124

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
6105787107 2020-04-14 0459 PPP 2068 Valleydale Rd, BIRMINGHAM, AL, 35244
Loan Status Date 2021-02-20
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 76057
Loan Approval Amount (current) 76057
Undisbursed Amount 0
Franchise Name -
Lender Location ID 44449
Servicing Lender Name PNC Bank, National Association
Servicing Lender Address 222 Delaware Ave, WILMINGTON, DE, 19801-1621
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address BIRMINGHAM, JEFFERSON, AL, 35244-1000
Project Congressional District AL-06
Number of Employees 5
NAICS code 621111
Borrower Race Asian
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 760
Originating Lender Name First Source Federal Credit Union
Originating Lender Address Rome, NY
Gender Female Owned
Veteran Non-Veteran
Forgiveness Amount 76652.78
Forgiveness Paid Date 2021-01-28
4486808405 2021-02-06 0459 PPS 2068 Valleydale Rd, Hoover, AL, 35244-2092
Loan Status Date 2021-10-07
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 82825
Loan Approval Amount (current) 82825
Undisbursed Amount 0
Franchise Name -
Lender Location ID 44449
Servicing Lender Name PNC Bank, National Association
Servicing Lender Address 222 Delaware Ave, WILMINGTON, DE, 19801-1621
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Hoover, SHELBY, AL, 35244-2092
Project Congressional District AL-06
Number of Employees 8
NAICS code 621111
Borrower Race Asian
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 44449
Originating Lender Name PNC Bank, National Association
Originating Lender Address WILMINGTON, DE
Gender Female Owned
Veteran Non-Veteran
Forgiveness Amount 83349.56
Forgiveness Paid Date 2021-09-27

Date of last update: 03 Aug 2024

Sources: Alabama Secretary of State