Name: | Complete Family Medicine, Inc. |
Jurisdiction: | Alabama |
Legal type: | Domestic Corporation |
Status: | Exists |
Date of registration: | 16 Feb 1999 (26 years ago) |
Entity Number: | 000-200-850 |
Register Number: | 000200850 |
County: | Shelby |
Place of Formation: | Shelby County |
Principal Address: | PELHAM, AL |
Registered Office Street Address: | 2122 OLD MONTGOMERY HIGHWAYPELHAM, AL 35124 |
Registered Office Street Address ZIP Code: | 35124 |
Authorized Capital: | $100 |
Paid Share Capital: | $100 |
Activities
OPERATE A FAMILY MEDICAL PRACTICE
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1154362655 | 2006-06-08 | 2020-08-22 | PO BOX 638, CULLMAN, AL, 350560638, US | 1908 CHEROKEE AVE SW, CULLMAN, AL, 350555502, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
Phone | +1 256-737-9416 |
Fax | 2567365684 |
Authorized person
Name | JAMES THOMAS |
Role | FINANCIAL DIRECTOR |
Phone | 2567379416 |
Taxonomy
Taxonomy Code | 208100000X - Physical Medicine & Rehabilitation Physician |
Is Primary | No |
Taxonomy Code | 305R00000X - Preferred Provider Organization |
Is Primary | No |
Other Provider Identifiers
Issuer | BLUE CROSS |
Number | 051507133 |
State | AL |
Issuer | NPI |
Number | 1366514945 |
Issuer | NPI |
Number | 1588603807 |
State | AL |
Issuer | RRMC |
Number | 080148738 |
State | AL |
Issuer | NPI |
Number | 1235175886 |
State | AL |
Issuer | NPI |
Number | 1629093638 |
State | AL |
Issuer | MEDICAID |
Number | 009912575 |
State | AL |
Issuer | TRICARE |
Number | 438170475 |
Name | Role |
---|---|
THOMAS, JAMES V III | Agent |
Name | Role |
---|---|
THOMAS, JAMES V III | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State