| Name: | PainSouth, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 24 Jun 1998 (26 years ago) |
| Entity Number: | 000-196-345 |
| Register Number: | 000196345 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 420 N 20TH ST, 3100 SOUTH TRUST TOWERBIRMINGHAM, AL 35203 |
| Registered Office Street Address ZIP Code: | 35203 |
| Authorized Capital: | $1,000 |
Activities
PRACTICE OF MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1447210844 | 2006-03-28 | 2022-02-09 | 5184 CALDWELL MILL RD STE 204-334, HOOVER, AL, 352441912, US | 5184 CALDWELL MILL RD STE 204-334, HOOVER, AL, 352441912, US | |||||||||||||||||||||||||||||
|
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| Phone | +1 205-266-3235 |
| Fax | 2052979804 |
Authorized person
| Name | DAVID W COSGROVE |
| Role | PRESIDENT |
| Phone | 2052663235 |
Taxonomy
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 208VP0014X - Interventional Pain Medicine Physician |
| License Number | 19927 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529804180 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| RAWLS, BRUCE A | Agent | 420 20TH ST N STE 3400BIRMINGHAM, AL 35203 |
| Name | Role |
|---|---|
| COSGROVE, DAVID W | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
