| Name: | Vista Med-Supply, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 13 Jan 1989 (36 years ago) (Companies founded in January 1989) |
| Date of dissolution: | 27 Dec 2018 |
| Entity Number: | 000-128-457 |
| Register Number: | 000128457 |
| ZIP code: | 35121 (Companies in Blount, 35121) |
| County: | Blount |
| Place of Formation: | Blount County |
| Principal Address: | ONEONTA, AL |
| Registered Office Street Address: | 110 2ND AVENUE EASTONEONTA, AL 35121 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225010408 | 2005-11-15 | 2008-06-19 | 110 2ND AVE E, ONEONTA, AL, 351211714, US | 110 2ND AVE E, ONEONTA, AL, 351211714, US | |||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||
| Phone | +1 205-625-3099 |
| Fax | 2056253101 |
Authorized person
| Name | JOHN D HUIE |
| Role | MANAGER |
| Phone | 2056253099 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 409 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MS MEDICAID |
| Number | 00440612 |
| State | MS |
| Issuer | MEDICAID |
| Number | 009104060 |
| State | AL |
| Issuer | BLUE CROSS AND BLUE SHIEL |
| Number | 51057020 |
| State | AL |
| Name | Role |
|---|---|
| HUIE, JOHN D | Agent |
| Name | Role |
|---|---|
| HUIE, H MAX | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
