| 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
| 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 | |||||||||||||||||||||
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| 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
