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
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 | |||||||||||||||||||||||||
|
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 |
Name | Role |
---|---|
INFIRMARY MEDICAL CLINICS PC | Incorporator |
Name | Role |
---|---|
KOLB, GARY E | Agent |
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