| Name: | Aliceville Rural Health Clinic, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 31 Jul 1996 (28 years ago) (Companies founded in July 1996) |
| Date of dissolution: | 31 Dec 2013 |
| Entity Number: | 000-181-709 |
| Register Number: | 000181709 |
| ZIP code: | 35442 (Companies in Pickens, 35442) |
| County: | Pickens |
| Place of Formation: | Pickens County |
| Principal Address: | ALICEVILLE, AL |
| Registered Office Street Address: | 1400 CARROLLTON RDALICEVILLE, AL 35442 |
| Authorized Capital: | $100 |
| Paid Share Capital: | -- |
Activities
PROFESSIONAL MEDICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295788784 | 2006-05-18 | 2022-07-21 | 1400 CARROLLTON RD, ALICEVILLE, AL, 354421824, US | 1400 CARROLLTON RD, ALICEVILLE, AL, 354421823, US | |||||||||||||||||||||||||||||
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| Phone | +1 205-373-6323 |
| Fax | 2053732544 |
Authorized person
| Name | MR. JOHN TUTEN |
| Role | PRESIDENT |
| Phone | 2053736323 |
Taxonomy
| Taxonomy Code | 261QR1300X - Rural Health Clinic/Center |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000002251 |
| State | AL |
| Issuer | MEDICAID |
| Number | 541003868 |
| State | AL |
| Name | Role |
|---|---|
| GENTRY, JAMES H SR | Agent |
| Name | Role |
|---|---|
| GENTRY, JAMES H SR | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
