| Name: | The Vascular Institute of Birmingham, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 05 Mar 2008 (17 years ago) (Companies founded in March 2008) |
| Entity Number: | 000-256-415 |
| Register Number: | 000256415 |
| Place of Formation: | Jefferson County |
| Principal Address: | BIRMINGHAM, AL |
| Registered Office Street Address: | 1112 GENE REED ROADBIRMINGHAM, AL 35235-2405 |
| Authorized Capital: | $1,000 |
Activities
MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588988851 | 2010-03-16 | 2010-06-02 | PO BOX 661495, BIRMINGHAM, AL, 352661495, US | 2660 10TH AVE S, POB #1, SUITE 608, BIRMINGHAM, AL, 352051605, US | |||||||||||||||||||||||||||||||
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| Phone | +1 205-979-5882 |
| Fax | 2059791248 |
| Phone | +1 205-939-3495 |
| Fax | 2059180147 |
Authorized person
| Name | WILLIAM D WHITLEY |
| Role | PRESIDENT |
| Phone | 2059393495 |
Taxonomy
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | TRICARE |
| Number | 1588988851 |
| State | AL |
| Issuer | MEDICAID |
| Number | 118563 |
| State | AL |
| Name | Role |
|---|---|
| WHITLEY, W DAVID | Agent |
| Name | Role |
|---|---|
| WHITLEY, W DAVID | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
