| Name: | Bradley S. Drake, PC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 19 Jun 2003 (21 years ago) (Companies founded in June 2003) |
| Entity Number: | 000-229-594 |
| Register Number: | 000229594 |
| ZIP code: | 35640 (Companies in Morgan, 35640) |
| County: | Morgan |
| Place of Formation: | Morgan County |
| Principal Address: | HARTSELLE, AL |
| Registered Office Street Address: | 240 HWY 31 S UNIT 41HARTSELLE, AL 35640 |
| Authorized Capital: | 1,000 NPV |
Activities
LAW PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407828379 | 2006-02-06 | 2023-02-01 | 697 HIGHWAY 31 NW, HARTSELLE, AL, 356404408, US | 697 HIGHWAY 31 NW, SUITE 41, HARTSELLE, AL, 356404408, US | |||||||||||||||||||||||||||||
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| Phone | +1 256-773-3997 |
| Fax | 2567733997 |
Authorized person
| Name | DR. BRAD DRAKE |
| Role | PRESIDENT |
| Phone | 2567733997 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | S-A49-TA-629 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 152W00000X - Optometrist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009937485 |
| State | AL |
| Name | Role |
|---|---|
| DRAKE, BRADLEY S | Agent |
| Name | Role |
|---|---|
| DRAKE, BRADLEY S | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
