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Alabama Pulmonary & Critical Care, P.C.

Details

Name: Alabama Pulmonary & Critical Care, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Dissolved
Date of registration: 18 Oct 2001 (23 years ago)
Date of dissolution: 01 Dec 2016
Entity Number: 000-219-363
Register Number: 000219363
County: Montgomery
Place of Formation: Montgomery County
Principal Address: MONTGOMERY, AL
Registered Office Street Address: 8230 OLD FEDERAL RDMONTGOMERY, AL 36117
Registered Office Street Address ZIP Code: 36117
Authorized Capital: $1,000

Activities PRACTICE MEDICINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1912978792 2006-01-30 2020-08-22 1722 PINE ST, SUITE 406, MONTGOMERY, AL, 361061103, US 1722 PINE ST, SUITE 406, MONTGOMERY, AL, 361061103, US

Contacts

Phone +1 334-834-5152
Fax 3348345167

Authorized person

Name STEPHANIE TRAYWICK
Role OFFICE MANAGER
Phone 3348345152

Taxonomy

Taxonomy Code 207RC0200X - Critical Care Medicine (Internal Medicine) Physician
License Number 20155
State AL
Is Primary No
Taxonomy Code 207RP1001X - Pulmonary Disease Physician
License Number 20155
State AL
Is Primary No

Other Provider Identifiers

Issuer BCBS
Number 515-05275
State AL

Agent

Name Role
BAJAJ, AKSHAY K Agent

Incorporator

Name Role
BAJAJ, AKSHAY K Incorporator

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State