Alabama Cardiology, P.C.

Contacts

Phone	+1 256-882-1450
Fax	2568823823

Authorized person

Name	DR. SADASIVA RAO KATTA
Role	PRESIDENT
Phone	2568821450

Taxonomy

Taxonomy Code	207RC0000X - Cardiovascular Disease Physician
Is Primary	Yes

Other Provider Identifiers

Issuer	MEDICAID
Number	000026675
State	AL

Three-digit plan number (PN)	003
Effective date of plan	2019-01-01
Business code	621111
Sponsor’s telephone number	2565411778
Plan sponsor’s address	4700 WHITEBURG DR, SUITE 200, HUNTSVILLE, AL, 35802

Signature of

Role	Plan administrator
Date	2024-09-20
Name of individual signing	SADASIVA KATTA
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	003
Effective date of plan	2019-01-01
Business code	621111
Sponsor’s telephone number	2565411778
Plan sponsor’s address	4700 WHITEBURG DR, SUITE 200, HUNTSVILLE, AL, 35802

Signature of

Role	Plan administrator
Date	2024-07-31
Name of individual signing	SADASIVA KATTA

File	View Page
Three-digit plan number (PN)	003
Effective date of plan	2019-01-01
Business code	621111
Sponsor’s telephone number	2565411778
Plan sponsor’s address	4700 WHITEBURG DR, SUITE 200, HUNTSVILLE, AL, 35802

Signature of

Role	Plan administrator
Date	2023-08-07
Name of individual signing	SADASIVA KATTA

File	View Page
Three-digit plan number (PN)	003
Effective date of plan	2019-01-01
Business code	621111
Sponsor’s telephone number	2565411778
Plan sponsor’s address	4700 WHITEBURG DR, SUITE 200, HUNTSVILLE, AL, 35802

Signature of

Role	Plan administrator
Date	2022-09-26
Name of individual signing	SADASIVA KATTA

File	View Page
Three-digit plan number (PN)	003
Effective date of plan	2019-01-01
Business code	621111
Sponsor’s telephone number	2565411778
Plan sponsor’s address	4700 WHITEBURG DR, SUITE 200, HUNTSVILLE, AL, 35802

Signature of

Role	Plan administrator
Date	2021-10-10
Name of individual signing	SADASIVA KATTA

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2019-01-01
Business code	621111
Sponsor’s telephone number	2565411778
Plan sponsor’s address	4700 WHITEBURG DR, SUITE 200, HUNTSVILLE, AL, 35802

Signature of

Role	Plan administrator
Date	2020-07-24
Name of individual signing	SADASIVA KATTA