Search icon

Primary Care Providers of America, LLC

Details

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) (Companies founded in December 2011)
Date of dissolution: 14 Dec 2017
Entity Number: 000-034-522
Register Number: 000034522
ZIP code: 36106 (Companies in Montgomery, 36106)
County: Montgomery
Place of Formation: Montgomery County
Principal Address: 4212 CARMICHAEL COURT NMONTGOMERY, AL 36106
Registered Office Street Address: 4212 CARMICHEL COURT NMONTGOMERY, AL 36106

Activities OPERATE UNDER RULES BY THE CENTER FOR MEDICARE SERVICES SHARED

National Provider Identifier

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

Contacts

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

Agent

Name Role Address
REEVES, MICHAEL L Agent 4142 CARMICHAEL ROADMONTGOMERY, AL 36106

Organizer

Name Role Address
REEVES, MICHAEL L Organizer 4142 CARMICHAEL ROADMONTGOMERY, AL 36106

Date of last update: 30 Jul 2024

Sources: Alabama Secretary of State