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WV Medical Services, P.C.

Details

Name: WV Medical Services, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 31 Jan 2000 (25 years ago) (Companies founded in January 2000)
Entity Number: 000-207-991
Register Number: 000207991
ZIP code: 35401 (Companies in Tuscaloosa, 35401)
County: Tuscaloosa
Place of Formation: Tuscaloosa County
Principal Address: TUSCALOOSA, AL
Registered Office Street Address: 572 25TH STTUSCALOOSA, AL 35401
Authorized Capital: $100

Activities PRACTICE GENERAL MEDICINE

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
E7CFKPY7KMT6 2024-07-02 4280 WATERMELON RD, STE 112, NORTHPORT, AL, 35473, 5163, USA 4280 WATERMELON RD, STE 112, NORTHPORT, AL, 35473, 5163, USA

Business Information

Congressional District 07
State/Country of Incorporation AL, USA
Activation Date 2023-07-05
Initial Registration Date 2021-09-30
Entity Start Date 2000-02-29
Fiscal Year End Close Date Dec 31

Points of Contacts

Electronic Business
Title PRIMARY POC
Name DAWN HOGGLE
Address 4280 WATERMELON RD STE 112, NORTHPORT, AL, 35473, 5250, USA
Government Business
Title PRIMARY POC
Name DAWN HOGGLE
Address 4280 WATERMELON RD STE 112, NORTHPORT, AL, 35473, 5250, USA
Past Performance Information not Available

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1497739346 2005-12-05 2023-09-27 4280 WATERMELON RD STE 112, NORTHPORT, AL, 354735250, US 4280 WATERMELON RD STE 112, NORTHPORT, AL, 354735250, US

Contacts

Phone +1 205-750-0030
Fax 2057500855

Authorized person

Name RICHARD EDWIN JONES III
Role OWNER
Phone 2057500030

Taxonomy

Taxonomy Code 207RR0500X - Rheumatology Physician
License Number 00019352
State AL
Is Primary Yes

Other Provider Identifiers

Issuer BCBS
Number 51504044
State AL
Issuer MEDICAID
Number 529912100
State AL

Agent

Name Role Address
JONES, RICHARD Agent 2720 SHANANDOAH CTMOBILE, AL 36695

Incorporator

Name Role Address
LINDSEY, DANIEL L JR Incorporator 184 COMMERCE STREETMONTGOMERY, AL 36104-3960

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State