| Name: | Sapp Family Medical, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 21 Dec 2001 (23 years ago) |
| Date of dissolution: | 28 May 2013 |
| Entity Number: | 000-220-251 |
| Register Number: | 000220251 |
| County: | Baldwin |
| Place of Formation: | Baldwin County |
| Principal Address: | DAPHNE, AL |
| Registered Office Street Address: | 28,119 N MAIN ST STE BDAPHNE, AL 36526 |
| Registered Office Street Address ZIP Code: | 36526 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
Activities
PRACTICE MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1235111956 | 2005-11-17 | 2007-09-04 | PO BOX 70076, MOBILE, AL, 366701076, US | 28119 N MAIN ST, SUITE B, DAPHNE, AL, 365267037, US | |||||||||||||||||||||
|
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| Phone | +1 251-621-0425 |
| Fax | 2514765460 |
Authorized person
| Name | DR. THOMAS F SAPP |
| Role | PRESIDENT/OWNER |
| Phone | 2516210425 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 51503627 |
| State | AL |
| Name | Role |
|---|---|
| SAPP, THOMAS F | Agent |
| Name | Role |
|---|---|
| SAPP, THOMAS F | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
