| Name: | Shri Krishan, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 15 Jun 2010 (14 years ago) |
| Date of dissolution: | 20 Sep 2023 |
| Entity Number: | 000-264-533 |
| Register Number: | 000264533 |
| County: | Madison |
| Place of Formation: | Madison County |
| Principal Address: | HUNTSVILLE, AL |
| Registered Office Street Address: | 104 EARLY MORNING CIRCLEHUNTSVILLE, AL 35811 |
| Registered Office Street Address ZIP Code: | 35811 |
| Authorized Capital: | $1,000 |
Activities
MEDICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1821303751 | 2010-08-16 | 2011-02-03 | 5107 MOORES MILL RD, HUNTSVILLE, AL, 358111007, US | 5107 MOORES MILL RD, HUNTSVILLE, AL, 358111007, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 256-851-7190 |
| Fax | 2568517189 |
Authorized person
| Name | DR. ARCHANA RASTOGI |
| Role | PRESIDENT |
| Phone | 2564268393 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | 21023 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | 21023 |
| State | AL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 113357 |
| State | AL |
| Name | Role |
|---|---|
| RASTOGI, ARCHANA | Agent |
| Name | Role |
|---|---|
| RASTOGI, ARCHANA | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
