| Name: | Pike Internal Medicine, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 01 Apr 1988 (37 years ago) |
| Entity Number: | 000-123-464 |
| Register Number: | 000123464 |
| County: | Pike |
| Place of Formation: | Pike County |
| Principal Address: | TROY, AL |
| Registered Office Street Address: | 1350 HWY 231 SOTROY, AL 36081 |
| Registered Office Street Address ZIP Code: | 36081 |
| Authorized Capital: | $5,000 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679779177 | 2007-06-22 | 2008-04-02 | 1350 HWY 231 SO, TROY, AL, 36081, US | 664 VETERANS BLVD, BRUNDIDGE, AL, 36010, US | |||||||||||||||||||||||||
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| Phone | +1 334-566-1270 |
| Fax | 3345661296 |
Authorized person
| Name | MRS. CHERYL DICHIARA |
| Role | SECRETARY |
| Phone | 3345661270 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | 00006320 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 52880960 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| HUTCHINSON, HENRY H | Incorporator | NOT POVIDEDMONTGOMERY, AL 36102-2069 |
| Name | Role |
|---|---|
| DICHIARA, PETER M | Agent |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
