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Valley Medical Clinic LLC

Details

Name: Valley Medical Clinic LLC
Jurisdiction: Alabama
Legal type: Domestic Professional Limited Liability Company
Status: Exists
Date of registration: 01 May 2017 (8 years ago)
Entity Number: 000-390-324
Register Number: 000390324
ZIP code: 35765
County: Jackson
Place of Formation: Jackson County
Registered Office Street Address: 6110 COUNTY RD 88PISGAH, AL 35765

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
H9SVUMG5BKR1 2022-07-24 1436 GUNTER AVE, GUNTERSVILLE, AL, 35976, USA 1436 GUNTER AVEUNE, GUNTERSVILLE, AL, 35976, 1846, USA

Business Information

Division Name VALLEY MEDICAL CLINIC, LLC
Division Number VALLEY MED
Congressional District 04
State/Country of Incorporation AL, USA
Activation Date 2021-06-24
Initial Registration Date 2021-06-08
Entity Start Date 2020-02-10
Fiscal Year End Close Date Dec 31

Points of Contacts

Electronic Business
Title PRIMARY POC
Name MUHAMMAD E ATA
Address 1436 GUNTER AVEUNE, GUNTERSVILLE, AL, 35765, 1846, USA
Government Business
Title PRIMARY POC
Name MUHAMMAD E ATA
Address 1436 GUNTER AVEUNE, GUNTERSVILLE, AL, 35768, 1846, USA
Past Performance Information not Available

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1063948891 2017-05-11 2017-08-28 PO BOX 56, 331 PARKS AVENUE, SCOTTSBORO, AL, 357680056, US 331 PARKS AVE, SCOTTSBORO, AL, 357682411, US

Contacts

Phone +1 256-451-1250
Fax 2564511270

Authorized person

Name MUHAMMAD E ATA
Role OWNER
Phone 2564511250

Taxonomy

Taxonomy Code 261Q00000X - Clinic/Center
Is Primary No
Taxonomy Code 261QR1300X - Rural Health Clinic/Center
Is Primary Yes

Agent

Name Role Address
ATA, MUHAMMAD Agent 6110 COUNTY ROAD 88PISGAH, AL 35765

Organizer

Name Role Address
ATA, MUHAMMAD Organizer 6110 COUNTY ROAD 88PISGAH, AL 35765

Date of last update: 13 Aug 2024

Sources: Alabama Secretary of State