Search icon

Alabama Eye Surgery, P.C.

Details

Name: Alabama Eye Surgery, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Dissolved
Date of registration: 13 Sep 2004 (20 years ago) (Companies founded in September 2004)
Date of dissolution: 02 Mar 2023
Entity Number: 000-237-356
Register Number: 000237356
ZIP code: 35211 (Companies in Jefferson, 35211)
County: Jefferson
Place of Formation: Jefferson County
Principal Address: BIRMINGHAM, AL
Registered Office Street Address: 801 PRINCETON AVE SWBIRMINGHAM, AL 35211
Authorized Capital: $1,000

Activities OPHTHALMOLOGY PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1184680647 2006-04-25 2009-07-17 PO BOX 10992, BIRMINGHAM, AL, 352020992, US 801 PRINCETON AVE SW, STE 530, BIRMINGHAM, AL, 352111310, US

Contacts

Phone +1 205-787-1411
Fax 2057872603

Authorized person

Name BRUCE SHELBY EICH
Role MEDICAL DOCTOR OWNER
Phone 2057871411

Taxonomy

Taxonomy Code 152W00000X - Optometrist
Is Primary No
Taxonomy Code 207W00000X - Ophthalmology Physician
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 529921660
State AL
Issuer BLUE CROSS OF ALABAMA
Number G042
State AL
Issuer RAILROAD MEDICARE GROUP
Number DC1578
State AL

Agent

Name Role
EICH, BRUCE S Agent

Incorporator

Name Role
OPHTHALMOLOGY ASSOCIATES PC Incorporator

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State