| Name: | Central Alabama Child Neurology, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 28 Jan 2011 (14 years ago) |
| Date of dissolution: | 04 May 2023 |
| Entity Number: | 000-001-638 |
| Register Number: | 000001638 |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Registered Office Mailing Address: | 640 WILTSHIRE DRIVEMONTGOMERY, AL 36117 |
| Registered Office Mailing Address ZIP Code: | 36117 |
| Registered Office Street Address: | 1722 PINE STREET SUITE 606MONTGOMERY, AL 36106 |
| Registered Office Street Address ZIP Code: | 36106 |
| Authorized Capital: | 1000 @ 1.00 PV |
| Paid Share Capital: | ------- |
Activities
PRACTICE OF GENERAL AND NEUROLOGY MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174820351 | 2011-02-23 | 2011-02-23 | 1722 PINE ST, SUITE 606, MONTGOMERY, AL, 361061103, US | 1722 PINE ST, SUITE 606, MONTGOMERY, AL, 361061103, US | |||||||||||||||||||||||
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| Phone | +1 334-618-0537 |
Authorized person
| Name | DR. LEAH O SANCHEZ |
| Role | PRESIDENT/OWNER |
| Phone | 3342074044 |
Taxonomy
| Taxonomy Code | 2084N0402X - Neurology with Special Qualifications in Child Neurology Physician |
| License Number | 22710 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 9457 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| SANCHEZ, LEAH O | Agent | 640 WILTSHIRE DRIVEMONTGOMERY, AL 36117 |
| Name | Role | Address |
|---|---|---|
| SANCHEZ, LEAH O | Director | 640 WILTSHIRE DRIVEMONTGOMERY, AL 36117 |
| Name | Role | Address |
|---|---|---|
| SANCHEZ, LEAH O | Incorporator | 640 WILTSHIRE DRIVEMONTGOMERY, AL 36117 |
Date of last update: 29 Jul 2024
Sources: Alabama Secretary of State
