| Name: | MOBILITY MEDICAL OF NORTH, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 01 Jan 2000 (25 years ago) |
| Entity Number: | 000-384-444 |
| Register Number: | 000384444 |
| Historical Names: |
MOBILITY MEDICAL NORTH, LLC
|
| Branch of: | MOBILITY MEDICAL OF NORTH, LLC, Mississippi (Company Number 883723) |
| ZIP code: | 36693 |
| County: | Mobile |
| Place of Formation: | Mississippi |
| Principal Mailing Address: | 554 PARK LANE STE BFLOWOOD, MS 39232 |
| Registered Office Street Address: | 2 NORTH JACKSON ST SUITE 605MONTGOMERY, AL 36104 |
| Principal Address: | 3954 DEMETROPOLISMOBILE, AL 36693 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356390702 | 2006-05-10 | 2023-07-18 | 554 PARK LN, STE B, FLOWOOD, MS, 392328895, US | 2565 HALLS MILL RD, UNIT F, MOBILE, AL, 36606, US | |||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 601-932-1001 |
| Fax | 6019322130 |
Authorized person
| Name | MRS. DANYELLE CARROLL |
| Role | CEO/OWNER |
| Phone | 6019321001 |
Taxonomy
| Taxonomy Code | 332BC3200X - Customized Equipment (DME) |
| License Number | 25882 |
| State | MS |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | AL BOARD OF HME SVS PROVIDERS |
| Number | 1406 |
| State | AL |
| Issuer | MEDICAID |
| Number | 200655 |
| State | AL |
| Issuer | MS BOARD OF PHARMACY PERMIT |
| Number | 0695311.1 |
| State | MS |
| Issuer | LA STATE LICENSE |
| Number | DME.000555 |
| State | LA |
| Issuer | MEDICAID |
| Number | 03630512 |
| State | MS |
| Name | Role |
|---|---|
| C T Corporation System | Agent |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2018-10-31 | Name Change | MOBILITY MEDICAL NORTH, LLC | MOBILITY MEDICAL OF NORTH, LLC |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
