| Name: | Riverside Family Medicine, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 02 May 2001 (24 years ago) |
| Entity Number: | 000-216-245 |
| Register Number: | 000216245 |
| Historical Names: |
Audra Busenlehner MD, P.C.
|
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Registered Office Street Address: | 4520 WATERMELON ROADNORTHPORT, AL 35473 |
| Registered Office Street Address ZIP Code: | 35473 |
| Authorized Capital: | 5,000 @ $1. PV |
| Paid Share Capital: | $1,000 |
Activities
PRACTICE MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1669445433 | 2006-02-10 | 2022-12-20 | 4520 WATERMELON RD, NORTHPORT, AL, 354735246, US | 4520 WATERMELON RD, NORTHPORT, AL, 354735246, US | |||||||||||||||
|
|||||||||||||||||||
| Phone | +1 205-752-7443 |
| Fax | 2055568868 |
Authorized person
| Name | SONYA CHAPIN |
| Role | OFFICE MANAGER |
| Phone | 2057527445 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| KATONA, KEVIN | Agent |
| Name | Role |
|---|---|
| BUSENLEHNER, AUDRA | Incorporator |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2016-03-08 | Name Change | Audra Busenlehner MD, P.C. | Riverside Family Medicine, P.C. |
| 2011-09-02 | Capital Change | $5,000 Authorized $1,000 Paid In | 5,000 @ $1. PV Authorized $1,000 Paid In |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
