| Name: | Mitchell C. Shirah, M.D., P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 07 May 1990 (35 years ago) (Companies founded in May 1990) |
| Entity Number: | 000-136-941 |
| Register Number: | 000136941 |
| ZIP code: | 36274 (Companies in Randolph, 36274) |
| County: | Randolph |
| Place of Formation: | Randolph County |
| Registered Office Street Address: | 32 MEDICAL DRIVEROANOKE, AL 36274 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
Activities
REAL ESTATE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1265603351 | 2008-03-17 | 2013-09-09 | 59664 HIGHWAY 22, ROANOKE, AL, 362744438, US | 59664 HIGHWAY 22, ROANOKE, AL, 362744438, US | |||||||||||||||||||||||||||||||
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| Phone | +1 334-863-8951 |
| Fax | 3348632361 |
Authorized person
| Name | MRS. STEPHANIE LYNN ESTES |
| Role | OFFICE MANAGER |
| Phone | 3348638951 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 9705 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | RAILROAD MEDICARE |
| Number | DC5335 |
| State | AL |
| Issuer | MEDICAID |
| Number | 5299921880 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| SHIRAH, MITCHELL C | Agent | 32 MEDICAL DRIVEROANOKE, AL 36274 |
| Name | Role | Address |
|---|---|---|
| SHIRAH, MITCHELL C | Incorporator | 32 MEDICAL DRIVEROANOKE, AL 36274 |
| Name | Role | Address |
|---|---|---|
| SHIRAH, MITCHELL C | Director | 32 MEDICAL DRIVEROANOKE, AL 36274 |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
