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North Alabama Primary Care, P.C.

Details

Name: North Alabama Primary Care, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 13 Nov 1996 (28 years ago)
Entity Number: 000-183-565
Register Number: 000183565
County: Limestone
Place of Formation: Limestone County
Principal Address: ATHENS, AL
Registered Office Street Address: 106 SANDERS STATHENS, AL 35611
Registered Office Street Address ZIP Code: 35611
Authorized Capital: $5,000
Paid Share Capital: $1,000

Activities MEDICAL PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1912118456 2007-05-25 2008-03-14 1015 HIGHWAY 72 EAST, SUITE 1, ATHENS, AL, 35611, US 1015 HIGHWAY 72 EAST, SUITE 1, ATHENS, AL, 35611, US

Contacts

Phone +1 256-232-2505
Fax 2562303226

Authorized person

Name DR. CHANDRA S KONERU
Role PHYSICIAN
Phone 2562322505

Taxonomy

Taxonomy Code 207R00000X - Internal Medicine Physician
Is Primary Yes

Other Provider Identifiers

Issuer RAILROAD MEDICARE
Number CI3887
State AL

Agent

Name Role Address
KONERU, CHANDRA S Agent 1015 US HWY 72 E STE AATHENS, AL 35611

Incorporator

Name Role Address
KONERU, CHANDRA S Incorporator 1015 US HWY 72 E STE AATHENS, AL 35611
KONERU, VIJAYA Incorporator No data

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State