| Name: | Cahaba Podiatry, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 15 Jan 1999 (26 years ago) |
| Date of dissolution: | 14 Dec 2022 |
| Entity Number: | 000-200-220 |
| Register Number: | 000200220 |
| County: | Shelby |
| Place of Formation: | Shelby County |
| Principal Address: | BIRMINGHAM, AL |
| Registered Office Street Address: | 5510 HWY 280 STE 211BIRMINGHAM, AL 35242 |
| Registered Office Street Address ZIP Code: | 35242 |
| Authorized Capital: | 1,000 |
Activities
MEDICAL & SURGICAL PODIATRY PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902836885 | 2006-07-04 | 2010-09-20 | PO BOX 273, CHELSEA, AL, 350430273, US | 5511 HIGHWAY 280, SUITE 124, BIRMINGHAM, AL, 352426585, US | |||||||||||||||||||||||||
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| Phone | +1 205-980-2005 |
| Fax | 2059806889 |
Authorized person
| Name | DR. LORA D. YEAGER-SMITH |
| Role | PRESIDENT |
| Phone | 2059802005 |
Taxonomy
| Taxonomy Code | 213ES0131X - Foot Surgery Podiatrist |
| License Number | 161 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS PROVIDER NUMBER |
| Number | 51046369 |
| State | AL |
| Name | Role |
|---|---|
| SMITH, RUSSELL L | Agent |
| Name | Role |
|---|---|
| SMITH, RUSSELL L | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
