| Name: | Pediatric Nephrology of Alabama, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 11 Jun 2010 (14 years ago) |
| Entity Number: | 000-264-477 |
| Register Number: | 000264477 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | GARDENDALE, AL |
| Registered Office Street Address: | 691 KENNEDY RDGARDENDALE, AL 35071 |
| Registered Office Street Address ZIP Code: | 35071 |
| Authorized Capital: | $5,000 |
Activities
MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245546993 | 2010-08-19 | 2010-08-19 | 1425 RICHARD ARRINGTON JR BLVD S, SUITE 206, BIRMINGHAM, AL, 352053898, US | 1425 RICHARD ARRINGTON JR BLVD S, SUITE 206, BIRMINGHAM, AL, 352053898, US | |||||||||||||||||||
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| Phone | +1 205-558-3200 |
| Fax | 2055582055 |
Authorized person
| Name | MAX MILLER |
| Role | BILLING MANAGER |
| Phone | 2565620025 |
Taxonomy
| Taxonomy Code | 2080P0210X - Pediatric Nephrology Physician |
| License Number | 12284 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BENFIELD, MARK | Agent | 691 KENNEDY ROADGARDENDALE, AL 35071 |
| Name | Role | Address |
|---|---|---|
| BENFIELD, MARK | Incorporator | 691 KENNEDY ROADGARDENDALE, AL 35071 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
