| Name: | Springhill Pediatrics, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 18 Feb 2003 (22 years ago) |
| Entity Number: | 000-227-509 |
| Register Number: | 000227509 |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Principal Address: | MOBILE, AL |
| Registered Office Street Address: | 4300 OLD SHELL ROADMOBILE, AL 36608 |
| Registered Office Street Address ZIP Code: | 36608 |
| Authorized Capital: | $1,000 |
Activities
MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760570683 | 2006-10-10 | 2020-08-22 | 4300 OLD SHELL RD, SUITE A, MOBILE, AL, 366082048, US | 4300 OLD SHELL RD, SUITE A, MOBILE, AL, 366082048, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 251-342-9928 |
| Fax | 2513429938 |
Authorized person
| Name | DONALD S FARQUHAR |
| Role | PRESIDENT |
| Phone | 2513429928 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS AL PROV # |
| Number | 51514333 |
| State | AL |
| Issuer | MEDICAID |
| Number | 52992960 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| SMITH, ANDREW L | Incorporator | 20 JAPONICA AVEMOBILE, AL 36606 |
| Name | Role |
|---|---|
| FARQUHAR, DONALD S | Agent |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
