| Name: | Magellan Provider Services, P.A. |
| Jurisdiction: | Alaska |
| Legal type: | Business Corporation |
| Status: | Good Standing |
| Date of registration: | 09 Nov 2022 (2 years ago) |
| Branch of: | Magellan Provider Services, P.A., FLORIDA (Company Number P21000078104) |
| Brand Name: | Magellan Provider Services, P.A., Inc. |
| Entity Number: | 10213081 |
| Place of Formation: | FLORIDA |
| Address: | 6303 COWBOYS WAY, SUITE 350, FRISCO, TX 75034 |
| Mailing Address: | 8621 ROBERT FULTON DRIVE, COLUBMIA, MD 21046 |
Line of Business
62 Health Care and Social AssistanceNAICS
621111 OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)| Name | Role |
|---|---|
| Brantley Jolly | Director |
| Brantley Jolly | President |
| Brantley Jolly | Secretary |
| Brantley Jolly | Shareholder |
| Brantley Jolly | Treasurer |
| Corporation Service Company | Registered Agent |
| Type | License Number | Status | Date of issue | Date of renewal | Expiration date | Description |
|---|---|---|---|---|---|---|
| Business License | 2168400 | Active | 2022-11-09 | - | 2024-12-31 | LOB: 62 - Health Care and Social Assistance, NAICS: 621111 - OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS) |
Date of last update: 10 Jan 2025
Sources: State of Alaska - Department of Commerce, Community, and Economic Development
