| Name: | Pedorthic Concepts, Inc |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 12 Sep 2002 (22 years ago) |
| Entity Number: | 000-225-062 |
| Register Number: | 000225062 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 601 VESTAVIA PARKWAY, SUITE 310VESTAVIA HILLS, AL 35216 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
Activities
PEDORTHIC SERVICES/PRODUCTS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1477637601 | 2006-10-24 | 2020-08-22 | 3021 LORNA RD, SUITE 300, BIRMINGHAM, AL, 352164587, US | 3021 LORNA RD, SUITE 300, BIRMINGHAM, AL, 352164587, US | |||||||||||||||||||||
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| Phone | +1 205-823-5580 |
| Fax | 2058235590 |
Authorized person
| Name | MR. DAVID GLENN FORD |
| Role | PRESIDENT |
| Phone | 2058235580 |
Taxonomy
| Taxonomy Code | 332BC3200X - Customized Equipment (DME) |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 51514840 |
| State | AL |
| Name | Role |
|---|---|
| O'DONNELL, MICHAEL R | Incorporator |
| Name | Role |
|---|---|
| DAVID G. FORD | Agent |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
