| Name: | Russellville Physician Practices, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Withdrawn |
| Date of registration: | 03 Dec 2003 (21 years ago) |
| Entity Number: | 000-606-045 |
| Register Number: | 000606045 |
| 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 | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174956841 | 2013-08-16 | 2013-08-16 | 15225 HIGHWAY 43, SUITE G, RUSSELLVILLE, AL, 356531999, US | 15225 HIGHWAY 43, SUITE G, RUSSELLVILLE, AL, 356531999, US | |||||||||||||||
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| Phone | +1 256-331-1900 |
| Fax | 2563311901 |
Authorized person
| Name | ANGIE MANGUM |
| Role | SENIOR DIRECTOR |
| Phone | 6155651898 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| C T CORPORATION SYSTEM | Agent | 2 NORHT JACKSON STREET SUITE 605MONTGOMERY, AL 36104 |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
