| Name: | Affinity Gastroenterology ASC, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 08 Dec 2017 (7 years ago) |
| Entity Number: | 000-409-842 |
| Register Number: | 000409842 |
| ZIP code: | 36104 |
| County: | Montgomery |
| Place of Formation: | Delaware |
| Principal Address: | 4000 MERIDIAN BLVDFRANKLIN, TN 37067 |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225698681 | 2019-06-18 | 2024-08-21 | 3686 GRANDVIEW PKWY STE 610, BIRMINGHAM, AL, 352433406, US | 3686 GRANDVIEW PKWY STE 610, BIRMINGHAM, AL, 352433406, US | |||||||||||||||
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| Phone | +1 205-971-3700 |
| Fax | 2059713701 |
Authorized person
| Name | KRISTY MUSIC |
| Role | AO- DIRECTOR, PROVIDER ENROLLMENT |
| Phone | 6154657377 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY INC | Agent | 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808 |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
