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Bay Minette Family Practice, P.C.

Details

Name: Bay Minette Family Practice, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Dissolved
Date of registration: 06 Oct 1995 (29 years ago) (Companies founded in October 1995)
Date of dissolution: 23 Mar 2021
Entity Number: 000-174-918
Register Number: 000174918
Historical Names: IMC-North Baldwin Family Practice, P.C.
IMC-Bay Minette Family Practice, P.C.
ZIP code: 36507 (Companies in Baldwin, 36507)
County: Baldwin
Place of Formation: Mobile County
Principal Address: MOBILE, AL
Registered Office Street Address: 2305 HAND AVENUE SUITE 2BAY MINETTE, AL 36507
Authorized Capital: $2,000
Paid Share Capital: ----

Activities MEDICAL RESEARCH/EDUCATION

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1467563163 2006-08-31 2009-05-26 2305 HAND AVE STE 2, BAY MINETTE, AL, 365074198, US 2305 HAND AVE STE 2, BAY MINETTE, AL, 365074198, US

Contacts

Phone +1 251-937-5652
Fax 2519375954

Authorized person

Name DR. GARY E KOLB
Role PRESIDENT
Phone 2519375652

Taxonomy

Taxonomy Code 261QP2300X - Primary Care Clinic/Center
License Number DO35
State AL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 000075536
State AL

Incorporator

Name Role
INFIRMARY MEDICAL CLINICS PC Incorporator

Agent

Name Role
KOLB, GARY E Agent

Events

Event Date Event Type Old Value New Value
2002-11-04 Name Change IMC-Bay Minette Family Practice, P.C. Bay Minette Family Practice, P.C.
1995-10-30 Name Change IMC-North Baldwin Family Practice, P.C. IMC-Bay Minette Family Practice, P.C.

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State