| Name: | Eastern Shore Foot Center, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 07 Jan 1993 (32 years ago) |
| Entity Number: | 000-154-092 |
| Register Number: | 000154092 |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Principal Address: | MOBILE, AL |
| Registered Office Street Address: | 5909 AIRPORT BLVDMOBILE, AL 36608 |
| Registered Office Street Address ZIP Code: | 36608 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
Activities
PODIATRY
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Y1ZJHYFHB6Q9 | 2024-10-18 | 1913 US HIGHWAY 98, DAPHNE, AL, 36526, 4371, USA | 1913 US HIGHWAY 98, DAPHNE, AL, 36526, 4371, USA | |||||||||||||||||||||||||||||||||||||||||
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| Congressional District | 01 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2023-10-23 |
| Initial Registration Date | 2022-09-27 |
| Entity Start Date | 1993-01-07 |
| Fiscal Year End Close Date | Dec 31 |
Service Classifications
| NAICS Codes | 621391 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | RANDELL BRAUN |
| Role | PHYSICIAN |
| Address | 1913 US HIGHWAY 98, DAPHNE, AL, 36526, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | RANDELL BRAUN |
| Role | PHYSICIAN |
| Address | 1913 US HIGHWAY 98, DAPHNE, AL, 36526, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417004656 | 2007-01-03 | 2010-11-18 | 1913 US HIGHWAY 98, DAPHNE, AL, 365264371, US | 1913 US HIGHWAY 98, DAPHNE, AL, 365264371, US | |||||||||||||||||||
|
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| Phone | +1 251-626-5065 |
| Fax | 2516267580 |
Authorized person
| Name | DR. RANDELL BRAUN |
| Role | PRESIDENT |
| Phone | 2516265065 |
Taxonomy
| Taxonomy Code | 213ES0131X - Foot Surgery Podiatrist |
| License Number | 82 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LAURENDINE, CHASE R | Agent | 5909 AIRPORT BLVDMOBILE, AL 36608 |
| Name | Role |
|---|---|
| BRAUN, RANDELL I | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
