| Name: | Cahaba Pathology, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 15 Nov 2004 (20 years ago) |
| Date of dissolution: | 19 Sep 2008 |
| Entity Number: | 000-238-246 |
| Register Number: | 000238246 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | BIRMINGHAM, AL |
| Registered Office Street Address: | 3520 COUNTRY WOOD LNBIRMINGHAM, AL 35243 |
| Registered Office Street Address ZIP Code: | 35243 |
| Authorized Capital: | $1,000 |
Activities
MEDICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245224294 | 2005-09-06 | 2020-08-22 | PO BOX 11407, DRAWER 1238, BIRMINGHAM, AL, 352460100, US | 644 2ND ST NE, SUITE 2, ALABASTER, AL, 350078824, US | |||||||||||||||||||||||||
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| Phone | +1 800-897-6169 |
| Fax | 8008976170 |
| Phone | +1 205-620-3329 |
| Fax | 2056644322 |
Authorized person
| Name | DR. DONALD CANTLEY |
| Role | PRESIDENT |
| Phone | 2056203329 |
Taxonomy
| Taxonomy Code | 207ZD0900X - Dermatopathology (Pathology) Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | GROUP # BCBS OF AL |
| Number | F883 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| CANTLEY, DONALD R | Agent | 5692 CHESTNUT TRACEHOOVER, AL 35244 |
| Name | Role | Address |
|---|---|---|
| CANTLEY, DONALD R | Incorporator | 5692 CHESTNUT TRACEHOOVER, AL 35244 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
