| Name: | North Jefferson Internal Medicine, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 29 Aug 2000 (24 years ago) (Companies founded in August 2000) |
| Date of dissolution: | 31 Dec 2015 |
| Entity Number: | 000-211-892 |
| Register Number: | 000211892 |
| ZIP code: | 35068 (Companies in Jefferson, 35068) |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | FULTONDALE, AL |
| Registered Office Street Address: | 2619 DECATUR HIGHWAYFULTONDALE, AL 35068 |
| Authorized Capital: | $1,000 |
Activities
SPECIALIZED IN THE PRACTICE OF INTERNAL MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124139282 | 2006-08-31 | 2010-08-31 | 2619 DECATUR HWY, FULTONDALE, AL, 350681723, US | 2619 DECATUR HWY, FULTONDALE, AL, 350681723, US | |||||||||||||||||||||||||||
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| Phone | +1 205-841-9898 |
| Fax | 2058419880 |
Authorized person
| Name | DR. GREG HILL. |
| Role | OWNER |
| Phone | 2058419898 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529910230 |
| State | AL |
| Issuer | MEDICARE PTAN |
| Number | I635 |
| State | AL |
| Name | Role |
|---|---|
| HILL, GREGORY GRIFFIN | Agent |
| Name | Role | Address |
|---|---|---|
| SCHIFF, GARY S | Incorporator | 420 20TH STREET NORTH, SUITE 1400BIRMINGHAM, AL 35203 |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
