Name: | Northwest Alabama Psychiatric Services, P.C. |
Jurisdiction: | Alabama |
Legal type: | Domestic Professional Corporation |
Status: | Exists |
Date of registration: | 16 May 1994 (30 years ago) |
Entity Number: | 000-164-213 |
Register Number: | 000164213 |
County: | Walker |
Place of Formation: | Jefferson County |
Principal Address: | BIRMINGHAM, AL |
Registered Office Street Address: | 4330 MEDICAL PLAZA EAST STE 106JASPER, AL 35501 |
Registered Office Street Address ZIP Code: | 35501 |
Authorized Capital: | $1,000 |
Paid Share Capital: | ---- |
Activities
ENGAGE IN PRACTICE OF MEDICINE
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1306448394 | 2020-11-13 | 2022-03-07 | 20 MEDICAL CENTER DR STE 300, JASPER, AL, 355013428, US | 20 MEDICAL CENTER DR STE 300, JASPER, AL, 355013428, US | |||||||||||||||
|
Phone | +1 205-384-0141 |
Fax | 2053840171 |
Authorized person
Name | TERRY WAYNE BENTLEY |
Role | OWNER/PSYCHIATRIST |
Phone | 2053840141 |
Taxonomy
Taxonomy Code | 2084B0040X - Behavioral Neurology & Neuropsychiatry Physician |
Is Primary | Yes |
Name | Role | Address |
---|---|---|
SMITH, RALPH H II | Incorporator | 1819 5TH AVENUE NORTH SUITE 1100BIRMINGHAM, AL 35203 |
Name | Role |
---|---|
BENTLEY, TERRY W MD | Agent |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State