| Name: | Shoals Ear, Nose & Throat Group, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 01 Oct 1984 (40 years ago) (Companies founded in October 1984) |
| Date of dissolution: | 08 Nov 2022 |
| Entity Number: | 000-100-278 |
| Register Number: | 000100278 |
| Historical Names: |
F. Allen Long, M.D., P.C.
|
| ZIP code: | 35660 (Companies in Colbert, 35660) |
| County: | Colbert |
| Place of Formation: | Colbert County |
| Principal Address: | SHEFFIELD, AL |
| Registered Office Street Address: | 505 NORTH COLUMBIA AVENUESHEFFIELD, AL 35660 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124105671 | 2006-11-01 | 2020-08-22 | 421 COX BLVD, SHEFFIELD, AL, 35660, US | 421 COX BLVD, SHEFFIELD, AL, 35660, US | |||||||||||||||||||||||||
|
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| Phone | +1 256-386-7040 |
| Fax | 2563837808 |
Authorized person
| Name | MS. PATRICIA LONG |
| Role | ADMINISTRATOR |
| Phone | 2563867040 |
Taxonomy
| Taxonomy Code | 207Y00000X - Otolaryngology Physician |
| License Number | 10880 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS AL |
| Number | 51011662 |
| State | AL |
| Name | Role |
|---|---|
| LONG, F ALLEN MD | Agent |
| Name | Role |
|---|---|
| LONG, F ALLEN MD | Incorporator |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 1989-05-24 | Name Change | F. Allen Long, M.D., P.C. | Shoals Ear, Nose & Throat Group, P.C. |
Date of last update: 31 Jul 2024
Sources: Alabama Secretary of State
