Search icon

North Shelby Family Health, P.C.

Details

Name: North Shelby Family Health, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 20 Oct 1995 (29 years ago)
Entity Number: 000-175-161
Register Number: 000175161
County: Jefferson
Place of Formation: Shelby County
Principal Address: BIRMINGHAM, AL
Registered Office Street Address: 2520 VALLEYDALE ROADBIRMINGHAM, AL 35244
Registered Office Street Address ZIP Code: 35244
Authorized Capital: $5,000

Activities MEDICAL PRACTICE; SPECIALIZING IN FAMILY PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1508976598 2006-08-30 2010-10-18 2520 VALLEYDALE RD, BIRMINGHAM, AL, 352442019, US 2520 VALLEYDALE RD, BIRMINGHAM, AL, 352442019, US

Contacts

Phone +1 205-980-9944
Fax 2059809844

Authorized person

Name MRS. CAROL J SIMS
Role OFFICE MANAGER
Phone 2059809944

Taxonomy

Taxonomy Code 207Q00000X - Family Medicine Physician
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 529700260
State AL

Agent

Name Role
MOORE, DOUGLAS O Agent

Incorporator

Name Role
MOORE, DOUGLAS O Incorporator
BLACKBURN, VANCE G Incorporator

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State