| Name: | Orthotic & Prosthetic Associates, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 21 Nov 2000 (24 years ago) |
| Date of dissolution: | 04 Jan 2024 |
| Entity Number: | 000-213-397 |
| Register Number: | 000213397 |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Principal Address: | MOBILE, AL |
| Registered Office Street Address: | 1725 SPRINGHILL AVEMOBILE, AL 36604 |
| Registered Office Street Address ZIP Code: | 36604 |
| Authorized Capital: | $1,000 |
Activities
MFG/SALE/FITTING OF PROSTHETICS/ORTHOTICS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033272638 | 2006-12-18 | 2017-03-27 | 1557 SPRING HILL AVE STE A, MOBILE, AL, 366043218, US | 1557 SPRING HILL AVE STE A, MOBILE, AL, 366043218, US | |||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 251-433-0400 |
| Fax | 2514339940 |
Authorized person
| Name | SELINA R GIBSON |
| Role | OFFICE MANAGER |
| Phone | 2514330400 |
Taxonomy
| Taxonomy Code | 335E00000X - Prosthetic/Orthotic Supplier |
| License Number | 25 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | HEALTH SPRINGS |
| Number | 48611 |
| State | AL |
| Issuer | SENIORS FIRST |
| Number | 48611 |
| State | AL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 51501036 |
| State | AL |
| Issuer | MEDICAID |
| Number | 009960730 |
| State | AL |
| Name | Role |
|---|---|
| LEE, CHARLES RANDALL | Agent |
| Name | Role |
|---|---|
| LEE, CHARLES RANDALL | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
