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