| Name: | Kevin A. Coady Family Practice, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Dissolved |
| Date of registration: | 08 Mar 2004 (21 years ago) |
| Date of dissolution: | 26 Dec 2013 |
| Entity Number: | 000-234-463 |
| Register Number: | 000234463 |
| County: | Autauga |
| Place of Formation: | Autauga County |
| Principal Address: | PRATTVILLE, AL |
| Registered Office Street Address: | 504 COOK RDPRATTVILLE, AL 36067 |
| Registered Office Street Address ZIP Code: | 36067 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
Activities
MEDICINE PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801879416 | 2005-11-29 | 2010-01-15 | PO BOX 680186, PRATTVILLE, AL, 360680186, US | 461 E MAIN ST, PRATTVILLE, AL, 360673409, US | |||||||||||||||||||||||||||||
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| Phone | +1 334-365-2217 |
| Fax | 3343617975 |
Authorized person
| Name | DR. KEVIN ANDREW COADY |
| Role | PRESIDENT |
| Phone | 3343652217 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 21360 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS ALABAMA |
| Number | 51521352 |
| Issuer | MEDICAID |
| Number | 009950405 |
| State | AL |
| Name | Role |
|---|---|
| COADY, KEVIN A | Agent |
| Name | Role |
|---|---|
| COADY, KEVIN A | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
