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LA GRANGE DIALYSIS, LLC

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Company Details

Name: LA GRANGE DIALYSIS, LLC
Legal type: Foreign Limited Liability Company
Status: Inactive
Standing: Good
Profit or Non-Profit: Profit
File Date: 23 Jan 2006 (19 years ago)
Authority Date: 23 Jan 2006 (19 years ago)
Last Annual Report: 02 Jul 2008 (17 years ago)
Organization Number: 0630366
Principal Office: 601 HAWAII STREET , EL SEGUNDO , CA 90245
Place of Formation: DELAWARE

Registered Agent

Name Role
KY SECRETARY OF STATE Registered Agent

Member

Name Role
MANAGING MEMBER Renal Life Link, Inc. Member
MEMBER Abdul G. Buridi, M.D. Member

Organizer

Name Role
H.W. GUY SEAY Organizer

National Provider Identifier

NPI Number:
1710079876

Authorized Person:

Name:
THOMAS O USILTON JR.
Role:
SR VICE PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
3032097825
Fax:
5025842835

Assumed Names

Name Status Expiration Date
WEST BROADWAY DIALYSIS Inactive 2012-04-17

Filings

Name File Date
App. for Certificate of Withdrawal 2009-03-12
Annual Report 2008-07-02
Annual Report 2007-06-07
Certificate of Assumed Name 2007-04-17
Application for Certificate of Authority 2006-01-23

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Sources: Kentucky Secretary of State