| Name: | Shelby Podiatry, PC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 27 Dec 2005 (19 years ago) |
| Entity Number: | 000-244-870 |
| Register Number: | 000244870 |
| County: | Shelby |
| Place of Formation: | Shelby County |
| Principal Address: | ALABASTER, AL |
| Registered Office Street Address: | 227 HWY 31 NORTHALABASTER, AL 35007 |
| Registered Office Street Address ZIP Code: | 35007 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
Activities
PODIATRY CLINIC
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508134313 | 2011-12-07 | 2011-12-07 | 227 A 1ST STREET NORTH, ALABASTER, AL, 35007, US | 227 1ST ST N, STE A, ALABASTER, AL, 350078767, US | |||||||||||||||||||||||||
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| Phone | +1 205-663-3224 |
| Fax | 2056633416 |
Authorized person
| Name | DR. DARRON M BARRUS |
| Role | DOCTOR |
| Phone | 2056633224 |
Taxonomy
| Taxonomy Code | 213ES0131X - Foot Surgery Podiatrist |
| License Number | 154 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 890020360 |
| State | AL |
| Name | Role |
|---|---|
| BARRUS, DARRON M | Agent |
| Name | Role |
|---|---|
| BARRUS, DARRON M | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
