| Name: | Carraway Internal Medicine Associates, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 08 Jun 2000 (24 years ago) (Companies founded in June 2000) |
| Date of dissolution: | 23 Jan 2012 |
| Entity Number: | 000-210-305 |
| Register Number: | 000210305 |
| ZIP code: | 35234 (Companies in Jefferson, 35234) |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | BIRMINGHAM, AL |
| Registered Office Street Address: | 1528 CARRAWAY BLVD THIRD FLBIRMINGHAM, AL 35234 |
| Authorized Capital: | $1,000 |
Activities
PRACTICE OF MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760432983 | 2006-05-10 | 2009-02-19 | 1201 11TH AVE S, SUITE 305, BIRMINGHAM, AL, 352053410, US | 1201 11TH AVE S, SUITE 305, BIRMINGHAM, AL, 352053410, US | |||||||||||||||||||||
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| Phone | +1 205-939-4939 |
| Fax | 2059394938 |
Authorized person
| Name | DR. BEVERLY L CARRAWAY-HANDLEY |
| Role | PRESIDENT/OWNER |
| Phone | 2059394939 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529905710 |
| State | AL |
| Name | Role |
|---|---|
| CARRAWAY-HANDLEY, BEVERLY | Agent |
| Name | Role | Address |
|---|---|---|
| STEWART, WILLIAM B | Incorporator | 800 SHADES CREEK PARKWAY, SUITE 400BIRMINGHAM, AL 35209-1196 |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
