| Name: | MedPlex Outpatient Surgery Center, Ltd. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Partnership |
| Status: | Exists |
| Date of registration: | 01 Nov 1991 (33 years ago) |
| Entity Number: | 000-505-017 |
| Register Number: | 000505017 |
| ZIP code: | 35244 |
| County: | Jefferson |
| Place of Formation: | Shelby County |
| Principal Address: | 4511 SOUTHLAKE PARKWAYBIRMINGHAM, AL 35244 |
| Registered Office Street Address: | 2 NO JACKSON ST STE 605MONTGOMERY, AL 36104 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1750499950 | 2006-08-28 | 2024-10-11 | 4511 SOUTHLAKE PKWY, HOOVER, AL, 352443238, US | 4511 SOUTHLAKE PKWY, HOOVER, AL, 352443238, US | |||||||||||||||||||||||||
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| Phone | +1 205-985-4398 |
| Fax | 2054441786 |
Authorized person
| Name | KIRSTEN OCONNOR |
| Role | OFFICER / AUTHORIZED OFFICIAL |
| Phone | 6153767315 |
Taxonomy
| Taxonomy Code | 261QA1903X - Ambulatory Surgical Clinic/Center |
| License Number | U5901 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | ASC-0014C |
| State | AL |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 6190 POWERS FERRY RD STE 600ATLANTA, GA 30339 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
