| Name: | Cardiology Associates of West Alabama, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 03 Feb 1992 (33 years ago) |
| Entity Number: | 000-147-762 |
| Register Number: | 000147762 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Registered Office Street Address: | 4401 WATERMELON RDNORTHPORT, AL 35473 |
| Registered Office Street Address ZIP Code: | 35473 |
| Authorized Capital: | $5,000 |
Activities
CARDIOLOGY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669573721 | 2006-09-25 | 2024-06-14 | 4401 WATERMELON RD, NORTHPORT, AL, 354735197, US | 4401 WATERMELON RD, NORTHPORT, AL, 354735197, US | |||||||||||||||||||||
|
|||||||||||||||||||||||||
| Phone | +1 205-343-2811 |
| Fax | 2053910900 |
Authorized person
| Name | SAKINA KAMAL |
| Role | PRESIDENT |
| Phone | 2053432811 |
Taxonomy
| Taxonomy Code | 207RC0000X - Cardiovascular Disease Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529200580 |
| State | AL |
| Name | Role |
|---|---|
| HOLLEY, WARREN H | Agent |
| Name | Role |
|---|---|
| MAURITSON, DAVID R | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
