| Name: | Russellville Hospital, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Withdrawn |
| Date of registration: | 26 Jun 2002 (23 years ago) |
| Entity Number: | 000-604-359 |
| Register Number: | 000604359 |
| ZIP code: | 36104 |
| County: | Montgomery |
| Place of Formation: | Delaware |
| Principal Address: | 103 POWELL CT STE 200BRENTWOOD, TN 37027 |
| Registered Office Street Address: | 2 NORTH JACKSON ST., SUITE 605MONTGOMERY, AL 36104 |
Activities
HEALTHCARE SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508491093 | 2020-03-05 | 2022-11-21 | PO BOX 1216, RUSSELLVILLE, AL, 356531216, US | 13150 HIGHWAY 43 STE 10, RUSSELLVILLE, AL, 356534566, US | |||||||||||||||||||||
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| Phone | +1 256-331-2770 |
| Fax | 2563312777 |
| Phone | +1 256-332-5901 |
Authorized person
| Name | ASHOKE MUKHERJI |
| Role | CEO |
| Phone | 6157320768 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 261QR1300X - Rural Health Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| C T CORPORATION SYSTEM | Agent | 2 NORHT JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
