| Name: | Holley Medical, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 22 Jul 1994 (30 years ago) |
| Date of dissolution: | 15 Sep 2010 |
| Entity Number: | 000-165-642 |
| Register Number: | 000165642 |
| County: | Pike |
| Place of Formation: | Pike County |
| Principal Address: | TROY, AL |
| Registered Office Street Address: | 105 SOUTHLAND VILLAGETROY, AL 36081 |
| Registered Office Street Address ZIP Code: | 36081 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
Activities
CONDUCT & OPERATE A SURGICAL & MEDICAL EQUIPMENT/SUPPLY BUSINESS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1699710285 | 2006-06-18 | 2007-11-02 | 513 S BRUNDIDGE ST, TROY, AL, 360813333, US | 513 S BRUNDIDGE ST, TROY, AL, 360813333, US | |||||||||||||||||||||||||
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| Phone | +1 334-566-7963 |
| Fax | 3345660847 |
Authorized person
| Name | MICHAEL HOLLEY |
| Role | VICE PRESIDENT |
| Phone | 3345667963 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 173 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BC/BS PROVIDER NUMBER |
| Number | 56774 |
| State | AL |
| Name | Role |
|---|---|
| HOLLEY, DONALD RAY | Incorporator |
| Name | Role |
|---|---|
| HOLLEY, DONALD RAY | Agent |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
