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) (Companies founded in November 1996) |
Entity Number: | 000-183-565 |
Register Number: | 000183565 |
ZIP code: | 35611 (Companies in Limestone, 35611) |
County: | Limestone |
Place of Formation: | Limestone County |
Principal Address: | ATHENS, AL |
Registered Office Street Address: | 106 SANDERS STATHENS, AL 35611 |
Authorized Capital: | $5,000 |
Paid Share Capital: | $1,000 |
Activities
MEDICAL PRACTICE
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 | |||||||||||||||||||||
|
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 |
Name | Role | Address |
---|---|---|
KONERU, CHANDRA S | Agent | 1015 US HWY 72 E STE AATHENS, AL 35611 |
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