| Name: | Sand Mountain Internal Medicine and Geriatrics, Corp. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 23 Jun 2011 (13 years ago) |
| Entity Number: | 000-017-164 |
| Register Number: | 000017164 |
| County: | Marshall |
| Place of Formation: | Marshall County |
| Registered Office Street Address: | 605A MEDCIAL CENTER PKWYBOAZ, AL 35957 |
| Registered Office Street Address ZIP Code: | 35957 |
| Authorized Capital: | 100 @ $1 PV |
Activities
OUTPATIENT MEDICAL TREATMENT CENTER
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861771792 | 2011-08-09 | 2023-09-26 | 1981 CAHABA CV, HOOVER, AL, 352441823, US | 181 W VALLEY AVE STE 214, BIRMINGHAM, AL, 352093691, US | |||||||||||||||||||
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| Phone | +1 205-542-2713 |
| Phone | +1 205-732-3743 |
Authorized person
| Name | DR. WENDY RENEE WALKER |
| Role | PHYSICIAN/PRESIDENT |
| Phone | 2055422713 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | 2322 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GOMEZ, WENDY R | Agent | 1981 CAHABA COVEHOOVER, AL 35244 |
| Name | Role | Address |
|---|---|---|
| GOMEZ, WENDY R | Director | 1981 CAHABA COVEHOOVER, AL 35244 |
| Name | Role | Address |
|---|---|---|
| GOMEZ, WENDY R | Incorporator | 1981 CAHABA COVEHOOVER, AL 35244 |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
