| Name: | Trussville Family Healthcare, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 15 Dec 2004 (20 years ago) |
| Entity Number: | 000-238-708 |
| Register Number: | 000238708 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | TRUSSVILLE, AL |
| Registered Office Street Address: | 159 MAIN ST HWY 11TRUSSVILLE, AL 35173 |
| Registered Office Street Address ZIP Code: | 35173 |
| Authorized Capital: | $10,000 |
Activities
PRACTICE MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740477389 | 2007-09-27 | 2007-09-27 | 159 MAIN ST, TRUSSVILLE, AL, 351731435, US | 159 MAIN ST, TRUSSVILLE, AL, 351731435, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 205-655-2110 |
| Fax | 2056557020 |
Authorized person
| Name | DR. RANDOLPH LEE LAMBERSON |
| Role | CEO |
| Phone | 2056552110 |
Taxonomy
| Taxonomy Code | 173000000X - Legal Medicine |
| License Number | 15951 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BC OF ALABAMA |
| Number | 51001851 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| LAMBERSON, RANDOLPH L | Agent | 198 NARROWS DRIVEBIRMINGHAM, AL 35242 |
| Name | Role | Address |
|---|---|---|
| LEVITT, RONALD A | Incorporator | PO BOX 55727BIRMINGHAM, AL 35255-5727 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
