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Dark Side Medical LLC

Details

Name: Dark Side Medical LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 09 Apr 2010 (15 years ago)
Entity Number: 000-445-754
Register Number: 000445754
ZIP code: 35242
County: Shelby
Place of Formation: Montgomery County
Principal Address: MONTGOMERY, AL
Registered Office Street Address: 5130 CYRUS CIRCLEBIRMINGHAM, AL 35242

Activities MEDICAL SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1609153030 2011-11-14 2011-11-14 5130 CYRUS CIR, BIRMINGHAM, AL, 352424630, US 5130 CYRUS CIR, BIRMINGHAM, AL, 352424630, US

Contacts

Phone +1 205-981-0414
Fax 8883806501
Fax 8883306501

Authorized person

Name DR. VICTOR ESTRADA MENDOZA
Role OWNER AND TREATING PHYSICIAN
Phone 2569976182

Taxonomy

Taxonomy Code 261QM1300X - Multi-Specialty Clinic/Center
License Number 25607
State AL
Is Primary Yes

Agent

Name Role
CARR, KATHLEEN C Agent

Member

Name Role
MENDOZA, VICTOR ESTRADA Member

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
7872028300 2021-01-28 0459 PPS 5130 Cyrus Cir, Birmingham, AL, 35242-4630
Loan Status Date 2022-01-12
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 37610
Loan Approval Amount (current) 37610
Undisbursed Amount 0
Franchise Name -
Lender Location ID 12096
Servicing Lender Name Wells Fargo Bank, National Association
Servicing Lender Address 101 N Philips Ave, SIOUX FALLS, SD, 57104-6738
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Birmingham, SHELBY, AL, 35242-4630
Project Congressional District AL-06
Number of Employees 5
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 12096
Originating Lender Name Wells Fargo Bank, National Association
Originating Lender Address SIOUX FALLS, SD
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 37941.79
Forgiveness Paid Date 2021-12-21
7540837304 2020-04-30 0459 PPP 5130 CYRUS CIR, BIRMINGHAM, AL, 35242
Loan Status Date 2021-08-12
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 37542
Loan Approval Amount (current) 37542
Undisbursed Amount 0
Franchise Name -
Lender Location ID 12096
Servicing Lender Name Wells Fargo Bank, National Association
Servicing Lender Address 101 N Philips Ave, SIOUX FALLS, SD, 57104-6738
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address BIRMINGHAM, SHELBY, AL, 35242-0300
Project Congressional District AL-06
Number of Employees 4
NAICS code 621498
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 12096
Originating Lender Name Wells Fargo Bank, National Association
Originating Lender Address SIOUX FALLS, SD
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 37978.1
Forgiveness Paid Date 2021-07-06

Date of last update: 13 Aug 2024

Sources: Alabama Secretary of State