| Name: | Premise Health of Alabama Medical, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 31 Dec 1992 (32 years ago) (Companies founded in December 1992) |
| Entity Number: | 000-154-049 |
| Register Number: | 000154049 |
| Historical Names: |
HealthWorks Med Group of Alabama, PC
|
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Etowah County |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
| Authorized Capital: | $2 |
Activities
PRACTICE MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1811735954 | 2024-07-15 | 2024-07-15 | 5500 MARYLAND WAY STE 120, BRENTWOOD, TN, 370274993, US | 200 LOCKHEED MARTIN WAY # IB1, COURTLAND, AL, 356183646, US | |||||||||||||||
|
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| Phone | +1 256-637-1021 |
| Fax | 2566698352 |
Authorized person
| Name | JONATHAN LEIZMAN |
| Role | PRESIDENT |
| Phone | 6154686270 |
Taxonomy
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY INC | Agent | 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808 |
| Name | Role |
|---|---|
| HARDIES, MICHAEL J | Incorporator |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2022-01-05 | Name Change | HealthWorks Med Group of Alabama, PC | Premise Health of Alabama Medical, P.C. |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
