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Tupelo Urology Center, LLC

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Company Details

Name: Tupelo Urology Center, LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Good Standing
Effective Date: 22 Mar 2024 (a year ago)
Business ID: 1435094
ZIP code: 38655
County: Lafayette
State of Incorporation: MISSISSIPPI
Principal Office Address: 2168 SOUTH LAMAR BLVDOxford, MS 38655

Agent

Name Role Address
Brent Hardin Agent 2168 S. Lamar Boulevard, Oxford, MS 38655

Organizer

Name Role Address
Scott Shanker Organizer 100 Peabody Place, Suite 1300, Memphis, TN 38103

Member

Name Role Address
Brent M Hardin Member 2168 South Lamar Blvd, Oxford, MS 38655

National Provider Identifier

NPI Number:
1205684776
Certification Date:
2024-05-09

Authorized Person:

Name:
AMANDA NICOLE GARDNER
Role:
ADMINISTRATOR
Phone:

Taxonomy:

Selected Taxonomy:
261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary:
Yes

Contacts:

Filings

Type Status Filed Date Description
Annual Report LLC Filed 2025-02-06 Annual Report For Tupelo Urology Center, LLC
Formation Form Filed 2024-03-22 Formation For Tupelo Urology Center, LLC

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Date of last update: 05 Jun 2025

Sources: Company Profile on Mississippi Secretary of State Website