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Picayune Internal Medicine LLC

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Company Details

Name: Picayune Internal Medicine LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Good Standing
Effective Date: 21 May 2022 (3 years ago)
Business ID: 1341368
ZIP code: 39426
County: Pearl River
State of Incorporation: MISSISSIPPI
Principal Office Address: 200 GOLF COURSE DRIVECARRIERE, MS 39426

Agent

Name Role Address
Ahmad Haidar Agent 200 Country Club Rd, Picayune, MS 39466

Manager

Name Role Address
Ahmad Haidar Manager 200 Country Club Rd, Picayune, MS 39466

National Provider Identifier

NPI Number:
1033846068
Certification Date:
2022-08-01

Authorized Person:

Name:
JAMIE WILSON
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Filings

Type Status Filed Date Description
Reinstatement Filed 2025-05-15 Reinstatement For Picayune Internal Medicine LLC
Admin Dissolution Filed 2024-12-01 Action of Intent to Dissolve: AR: Picayune Internal Medicine LLC
Notice to Dissolve/Revoke Filed 2024-09-01 Notice of Intent to Dissolve: AR: Picayune Internal Medicine LLC
Annual Report LLC Filed 2023-09-13 Annual Report For Picayune Internal Medicine LLC
Notice to Dissolve/Revoke Filed 2023-09-08 Notice of Intent to Dissolve: AR: Picayune Internal Medicine LLC
Formation Form Filed 2022-05-21 Formation For Picayune Internal Medicine LLC

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Date of last update: 30 May 2025

Sources: Company Profile on Mississippi Secretary of State Website