| Name: | Artificial Limb and Brace Center, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 09 Oct 1992 (32 years ago) |
| Entity Number: | 000-152-531 |
| Register Number: | 000152531 |
| County: | Calhoun |
| Place of Formation: | Calhoun County |
| Registered Office Street Address: | 218 E 16TH STANNISTON, AL 36201 |
| Registered Office Street Address ZIP Code: | 36201 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
Activities
DESIGN & FABRICATE ARTIFICIAL LIMBS & BRACES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093768491 | 2006-05-18 | 2013-02-26 | 218 E 16TH ST, ANNISTON, AL, 362073810, US | 218 E 16TH ST, ANNISTON, AL, 362073810, US | |||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 256-236-2562 |
| Fax | 2562362521 |
Authorized person
| Name | MR. JACK S NEVILLS |
| Role | PRESIDENT/OWNER |
| Phone | 2562362562 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 005 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 335E00000X - Prosthetic/Orthotic Supplier |
| License Number | 005 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS PROVIDER NUMBER |
| Number | 51056129 |
| State | AL |
| Issuer | MEDICAID |
| Number | 000056129 |
| State | AL |
| CAGE number | Status | Type | Established | CAGE Update Date | CAGE Expiration | SAM Expiration | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 6Q702 | Active | U.S./Canada Manufacturer | 2012-04-12 | 2021-08-04 | 2025-02-26 | 2021-02-25 | |||||||||||||||
|
|||||||||||||||||||||
| POC | JACK NEVILLS |
| Phone | +1 256-236-2562 |
| Fax | +1 256-236-2521 |
| Address | 218 E 16TH ST, ANNISTON, AL, 36207 3810, UNITED STATES |
Ownership of Offeror Information
| Highest Level Owner | Information not Available |
|---|
| Immediate Level Owner | Information not Available |
|---|
| List of Offerors (0) | Information not Available |
|---|
| Name | Role |
|---|---|
| ARNOLD, THOMAS R | Incorporator |
| Name | Role | Address |
|---|---|---|
| NEVILLS, JACK | Agent | 218 E 16TH STANNISTON, AL 36201 |
| Name | Role | Address |
|---|---|---|
| NEVILLS, JACK | Director | 218 E 16TH STANNISTON, AL 36201 |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
