| Name: | Bridger Pathology Laboratories, P.A. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Association |
| Status: | Dissolved |
| Date of registration: | 06 Jul 1973 (51 years ago) (Companies founded in July 1973) |
| Date of dissolution: | 30 Dec 2009 |
| Entity Number: | 000-031-171 |
| Register Number: | 000031171 |
| Historical Names: |
Adams & Bridger Pathology Laboratories, P.A.
|
| Place of Formation: | Montgomery County |
| Principal Address: | 2055 NORMANDIE DRIVEMONTGOMERY, AL 36111-2745 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720034754 | 2006-05-25 | 2020-08-22 | 2055 NORMANDIE DR, SUITE 208, MONTGOMERY, AL, 361112732, US | 2055 NORMANDIE DR, SUITE 208, MONTGOMERY, AL, 361112732, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 334-288-4963 |
| Fax | 3342884250 |
Authorized person
| Name | DR. WILLIAM M BRIDGER |
| Role | PRESIDENT |
| Phone | 3342884963 |
Taxonomy
| Taxonomy Code | 291U00000X - Clinical Medical Laboratory |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS PROVIDER NUMBE |
| Number | 51076642 |
| State | AL |
| Issuer | BLUE CROSS PROVIDER NUMBE |
| Number | 51052284 |
| State | AL |
| Issuer | MEDICAID |
| Number | 51076442 |
| State | AL |
| Issuer | MEDICAID |
| Number | 51052284 |
| State | AL |
| Name | Role |
|---|---|
| BRIDGER, WILLIAM M MD | Member |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2004-06-21 | Name Change | Adams & Bridger Pathology Laboratories, P.A. | Bridger Pathology Laboratories, P.A. |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
