| Name: | Med 360 Urgent Care Winfield, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Limited Liability Company |
| Status: | Exists |
| Date of registration: | 14 Jul 2021 (4 years ago) |
| Entity Number: | 000-873-023 |
| Register Number: | 000873023 |
| ZIP code: | 35594 |
| County: | Marion |
| Place of Formation: | Marion County |
| Registered Office Street Address: | 125 BOB LAWRENCE ROAD SUITE CWINFIELD, AL 35594 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467120535 | 2021-09-02 | 2021-09-02 | PO BOX 1140, WINFIELD, AL, 355941140, US | 125 BOB LAWRENCE DRIVE, WINFIELD, AL, 35594, US | |||||||||||||||||||||
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| Phone | +1 205-487-4535 |
| Fax | 2054878875 |
Authorized person
| Name | FAROUK ANWARUL RAQUIB |
| Role | OWNER |
| Phone | 2054874535 |
Taxonomy
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 00032921 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| FAROUK RAQUIB | Agent | 125 BOB LAWRENCE ROAD SUITE CWINFIELD, AL 35594 |
| Name | Role | Address |
|---|---|---|
| FAROUK RAQUIB | Organizer | 125 BOB LAWRENCE ROAD SUITE CWINFIELD, AL 35594 |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
