| Name: | Athens Eye Care Center, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 09 Apr 2003 (22 years ago) |
| Entity Number: | 000-228-572 |
| Register Number: | 000228572 |
| County: | Limestone |
| Place of Formation: | Limestone County |
| Principal Address: | ATHENS, AL |
| Registered Office Street Address: | 309 W MARKET STATHENS, AL 35611 |
| Registered Office Street Address ZIP Code: | 35611 |
| Authorized Capital: | $1,000 |
Activities
OPTOMETRY MEDICINE PRACTICE
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| X1YQEHJPGV93 | 2024-05-21 | 22894 US HIGHWAY 72, ATHENS, AL, 35613, 7671, USA | 22894 US HIGHWAY 72, ATHENS, AL, 35613, 7671, USA | |||||||||||||||||||||||||||||||||||||||||
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| Division Name | ATHENS EYE CARE CENTER, P.C. |
| Congressional District | 05 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2023-05-24 |
| Initial Registration Date | 2023-04-18 |
| Entity Start Date | 2003-04-07 |
| Fiscal Year End Close Date | Dec 31 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | TERESA MILLER |
| Role | INSURANCE SPECIALIST |
| Address | 22894 US HIGHWAY 72, ATHENS, AL, 35613, 7671, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | TERESA MILLER |
| Role | INSURANCE SPECIALIST |
| Address | 22894 US HIGHWAY 72, ATHENS, AL, 35613, 7671, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881781268 | 2006-10-06 | 2019-03-05 | 22984 US HIGHWAY 72, ATHENS, AL, 35613, US | 22984 US HIGHWAY 72, ATHENS, AL, 35613, US | |||||||||||||||||||||||||
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| Phone | +1 256-232-2409 |
| Fax | 2562322402 |
Authorized person
| Name | DR. L. LEANNE WHITAKER |
| Role | PRESIDENT/SECRETARY |
| Phone | 2562322409 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | S889TA445 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529914941 |
| State | AL |
| Name | Role |
|---|---|
| WHITAKER, LAURA LEANNE | Agent |
| Name | Role |
|---|---|
| WHITAKER, LAURA LEANNE | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
