| Name: | Phenix City Pulmonary & Critical Care, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 30 Jul 2007 (17 years ago) (Companies founded in July 2007) |
| Entity Number: | 000-253-744 |
| Register Number: | 000253744 |
| ZIP code: | 36867 (Companies in Russell, 36867) |
| County: | Russell |
| Place of Formation: | Lee County |
| Principal Address: | PHENIX CITY, AL |
| Registered Office Street Address: | 5009 RIVERCHASE DR BLDG 600 STE APHENIX CITY, AL 36867 |
| Authorized Capital: | $10,000 |
Activities
PRACTICE MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619167350 | 2007-07-30 | 2012-01-28 | PO BOX 2585, COLUMBUS, GA, 319022585, US | 5009 RIVER CHASE DR, BLDG 600 STE A, PHENIX CITY, AL, 368677425, US | |||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 334-291-1288 |
| Fax | 3342911290 |
Authorized person
| Name | SYED M. MAHMOOD |
| Role | OWNER |
| Phone | 3342911288 |
Taxonomy
| Taxonomy Code | 207RC0200X - Critical Care Medicine (Internal Medicine) Physician |
| License Number | 28220 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 207RC0200X - Critical Care Medicine (Internal Medicine) Physician |
| License Number | 059999 |
| State | GA |
| Is Primary | No |
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| License Number | 28220 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 207RP1001X - Pulmonary Disease Physician |
| License Number | 059999 |
| State | GA |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529932959 |
| State | AL |
| Name | Role |
|---|---|
| MAHMOOD, SYED | Incorporator |
| Name | Role |
|---|---|
| MAHMOOD, SYED | Agent |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
