| Name: | Self Center, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 23 Jul 1991 (33 years ago) |
| Entity Number: | 000-144-418 |
| Register Number: | 000144418 |
| Historical Names: |
Self Center, Inc.
|
| County: | Baldwin |
| Place of Formation: | Baldwin County |
| Principal Address: | FAIRHOPE, AL |
| Registered Office Street Address: | 22353 COUNTY RD 27FAIRHOPE, AL 36532 |
| Registered Office Street Address ZIP Code: | 36532 |
| Authorized Capital: | $1,000 |
Activities
MARKET WEIGHT CONTROL & MEDICAL RESEARCH
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083832968 | 2007-04-23 | 2008-06-13 | 306 S GREENO RD, SUITE A, FAIRHOPE, AL, 365321905, US | 306 S GREENO RD, SUITE A, FAIRHOPE, AL, 365321905, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 251-928-8760 |
| Fax | 2519287028 |
Authorized person
| Name | KARL STANLEY SELF |
| Role | OWNER |
| Phone | 2519288760 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 6916 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS/BLUESHIELD OF ALABAMA |
| Number | 51083390 |
| State | AL |
| Name | Role |
|---|---|
| SELF, K S | Agent |
| Name | Role |
|---|---|
| SELF, K S | Incorporator |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 1995-05-22 | Name Change | Self Center, Inc. | Self Center, P.C. |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
