| Name: | Primary Care Providers of America, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 22 Dec 2011 (13 years ago) |
| Date of dissolution: | 14 Dec 2017 |
| Entity Number: | 000-034-522 |
| Register Number: | 000034522 |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Principal Address: | 4212 CARMICHAEL COURT NMONTGOMERY, AL 36106 |
| Principal Address ZIP Code: | 36106 |
| Registered Office Street Address: | 4212 CARMICHEL COURT NMONTGOMERY, AL 36106 |
| Registered Office Street Address ZIP Code: | 36106 |
Activities
OPERATE UNDER RULES BY THE CENTER FOR MEDICARE SERVICES SHARED
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811249170 | 2012-10-11 | 2012-10-11 | 4142 CARMICHAEL RD, MONTGOMERY, AL, 361062936, US | 4142 CARMICHAEL RD, MONTGOMERY, AL, 361062936, US | |||||||||||||||||||||
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| Phone | +1 334-213-8803 |
| Fax | 3342138803 |
| Fax | 3342138815 |
Authorized person
| Name | DR. MICHAEL L REEVES |
| Role | OWNER/PRESIDENT |
| Phone | 3342138803 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 10228 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| REEVES, MICHAEL L | Agent | 4142 CARMICHAEL ROADMONTGOMERY, AL 36106 |
| Name | Role | Address |
|---|---|---|
| REEVES, MICHAEL L | Organizer | 4142 CARMICHAEL ROADMONTGOMERY, AL 36106 |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
