| Name: | A. Lynn Ridgeway, MD, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 15 Jun 1999 (25 years ago) (Companies founded in June 1999) |
| Date of dissolution: | 12 Dec 2013 |
| Entity Number: | 000-203-417 |
| Register Number: | 000203417 |
| ZIP code: | 35203 (Companies in Jefferson, 35203) |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | BIRMINGHAM, AL |
| Registered Office Street Address: | 1901 SIXTH AVENUE NORTH STE 2400BIRMINGHAM, AL 35203 |
| Authorized Capital: | $1,000 |
Activities
PERFORM/RENDER PROFESSIONAL MEDICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639237340 | 2006-12-05 | 2012-06-20 | PO BOX 2587, MUSCLE SHOALS, AL, 356622587, US | 342 COX BLVD, SHEFFIELD, AL, 356604020, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 256-383-4473 |
| Fax | 2563815232 |
Authorized person
| Name | DR. A LYNN RIDGEWAY |
| Role | PRESIDENT |
| Phone | 2563834473 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | 17451 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 21679 |
| State | AL |
| Issuer | MEDICAID |
| Number | 000021679 |
| State | AL |
| Name | Role |
|---|---|
| BEAUBE, ELIZABETH G | Agent |
| Name | Role | Address |
|---|---|---|
| RIDGEWAY, A LYNN | Incorporator | 342 COX BOULEVARDSHEFFIELD, AL 35660 |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
