| Name: | Generations Primary Care,LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 28 Oct 2011 (13 years ago) (Companies founded in October 2011) |
| Entity Number: | 000-028-569 |
| Register Number: | 000028569 |
| ZIP code: | 35405 (Companies in Tuscaloosa, 35405) |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Registered Office Street Address: | 8810 ROLLING HILLS DRIVETUSCALOOSA, AL 35405 |
Activities
RENDER PROFESSIONAL MEDICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083985519 | 2012-01-13 | 2014-04-21 | 6531 HIGHWAY 69 S, SUITE A, TUSCALOOSA, AL, 354054087, US | 6531 HIGHWAY 69 S, TUSCALOOSA, AL, 354054087, US | |||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||
| Phone | +1 205-343-6979 |
| Fax | 2053453343 |
Authorized person
| Name | DR. KEISHA GIBSON LOWTHER |
| Role | PHYSICIAN/CEO |
| Phone | 2053436979 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | 26476 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 208000000X - Pediatrics Physician |
| License Number | 26476 |
| State | AL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| LOWTHER, KEISHA | Agent | 8810 ROLLING HILLS DRIVETUSCALOOSA, AL 35405 |
| Name | Role | Address |
|---|---|---|
| LOWTHER, KEISHA | Organizer | 8810 ROLLING HILLS DRIVETUSCALOOSA, AL 35405 |
| LOWTHER, JAMIE | Organizer | 8810 ROLLING HILLS DRIVETUSCALOOSA, AL 35405 |
| STAGGS, CLAY | Organizer | 701 22ND AVENUE, SUITE 1TUSCALOOSA, AL 35401 |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
