| Name: | Eufaula Eye Associates, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 03 Oct 1988 (36 years ago) |
| Entity Number: | 000-126-744 |
| Register Number: | 000126744 |
| County: | Barbour |
| Place of Formation: | Barbour County |
| Registered Office Street Address: | 138 E BROAD STEUFAULA, AL 36027 |
| Registered Office Street Address ZIP Code: | 36027 |
| Authorized Capital: | 100 @ $1.00 PV |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053478701 | 2007-01-02 | 2010-02-03 | PO BOX 635, EUFAULA, AL, 360720635, US | 138 E BROAD ST, EUFAULA, AL, 360272024, US | |||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 334-687-2545 |
| Fax | 3346876491 |
Authorized person
| Name | DR. HERNAN BENAVIDES |
| Role | OWNER |
| Phone | 3346872545 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | S387TA013 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000267495B |
| State | GA |
| Issuer | MEDICAID |
| Number | 528802120 |
| State | AL |
| Issuer | MEDICAID |
| Number | 000059471 |
| State | AL |
| Issuer | BCBS OF AL |
| Number | 51059471 |
| State | AL |
| Name | Role |
|---|---|
| BENAVIDES, RITA S | Agent |
| Name | Role |
|---|---|
| BENAVIDES, RITA S | Incorporator |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2014-12-15 | Capital Change | $100 Authorized --- Paid In | 100 @ $1.00 PV Authorized undefined Paid In |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
