| Name: | Crestani Family Medicine, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 21 Dec 2005 (19 years ago) |
| Entity Number: | 000-244-782 |
| Register Number: | 000244782 |
| County: | Madison |
| Place of Formation: | Madison County |
| Principal Address: | HUNTSVILLE, AL |
| Registered Office Street Address: | 2400 BOB WALLACE AVE STE 101HUNTSVILLE, AL 35805 |
| Registered Office Street Address ZIP Code: | 35805 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
Activities
ANY LAWFUL ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033166178 | 2006-05-27 | 2020-08-22 | PO BOX 2586, HUNTSVILLE, AL, 358042586, US | 2745 BOB WALLACE AVE SW, SUITE D, HUNTSVILLE, AL, 358054158, US | |||||||||||||||||||
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| Phone | +1 256-534-1323 |
| Fax | 2565341780 |
Authorized person
| Name | PANDA JO PALMER |
| Role | ACCOUNTS MANAGER |
| Phone | 2565341323 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 23539 |
| State | AL |
| Is Primary | Yes |
| Name | Role |
|---|---|
| CRESTANI, MARY MARGARET | Incorporator |
| Name | Role |
|---|---|
| LAMBERT, MICHAEL C | Agent |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
