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Northside Medical, Inc.

Details

Name: Northside Medical, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Exists
Date of registration: 17 Apr 2008 (17 years ago) (Companies founded in April 2008)
Entity Number: 000-257-066
Register Number: 000257066
ZIP code: 35989 (Companies in De Kalb, 35989)
County: De Kalb
Place of Formation: DeKalb County
Principal Address: VALLEY HEAD, AL
Registered Office Street Address: 760 CO RD 622VALLEY HEAD, AL 35989
Authorized Capital: $1,000

Activities ANY LAWFUL ACTIVITY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1205089372 2008-11-02 2008-11-02 PO BOX 680047, FORT PAYNE, AL, 359681601, US 211 GREENHILL BLVD NW, FORT PAYNE, AL, 359673755, US

Contacts

Phone +1 256-845-9355

Authorized person

Name DR. ROBERT W. THEAKSTON
Role PRESIDENT
Phone 2568459355

Taxonomy

Taxonomy Code 261QP2300X - Primary Care Clinic/Center
Is Primary Yes

Agent

Name Role
THEAKSTON, ROBERT Agent

Incorporator

Name Role
THEAKSTON, ROBERT Incorporator

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State