| Name: | Rubenstein Family Medical Associates, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 15 Jun 2007 (18 years ago) |
| Date of dissolution: | 09 Dec 2019 |
| Entity Number: | 000-495-964 |
| Register Number: | 000495964 |
| Historical Names: |
Rubenstein Family Medical Association, L.L.C.
|
| ZIP code: | 36571 |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Principal Address: | SARALAND, AL |
| Registered Office Street Address: | 1084 C INDUSTRIAL PKWYSARALAND, AL 36571 |
Activities
MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184718512 | 2006-10-02 | 2009-07-06 | 1084 INDUSTRIAL PARKWAY, SUITE C, SARALAND, AL, 365713725, US | 1084 INDUSTRIAL PARKWAY, SUITE C, SARALAND, AL, 365713725, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 251-675-5034 |
| Fax | 2516758511 |
Authorized person
| Name | HOWARD J RUBENSTEIN |
| Role | PHYSICIAN |
| Phone | 2516755034 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| License Number | MD10612 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| License Number | MD10612 |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 51048327 |
| State | AL |
| Issuer | MEDICAID |
| Number | 009937236 |
| State | AL |
| Name | Role |
|---|---|
| RUBENSTEIN, HOWARD JAY | Agent |
| Name | Role |
|---|---|
| RUBENSTEIN, HOWARD JAY | Member |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2008-03-06 | Name Change | Rubenstein Family Medical Association, L.L.C. | Rubenstein Family Medical Associates, L.L.C. |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
