| Name: | Alabama Providence Healthcare Services |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Exists |
| Date of registration: | 17 May 2013 (12 years ago) (Companies founded in May 2013) |
| Entity Number: | 000-272-616 |
| Register Number: | 000272616 |
| ZIP code: | 36608 (Companies in Mobile, 36608) |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
| Principal Address: | 6801 AIRPORT BOULEVARDMOBILE, AL 36608 |
Activities
REGLIGIOUS
CHARITABLE
SCIENTIFIC AND EDUCATIONAL PURPOSES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1609446087 | 2021-06-29 | 2021-06-29 | 6701 AIRPORT BLVD STE D436, MOBILE, AL, 366086705, US | 6701 AIRPORT BLVD STE D436, MOBILE, AL, 366086705, US | |||||||||||||||
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| Phone | +1 251-266-1987 |
| Fax | 2512662070 |
Authorized person
| Name | MIRANDA HEMM |
| Role | ENROLLMENT MANAGER |
| Phone | 9044506004 |
Taxonomy
| Taxonomy Code | 207RE0101X - Endocrinology, Diabetes & Metabolism Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WALKER, JAMES L | Director | 850 MALVERN BLVDSTONE MOUNTAIN, GA 30087 |
| GASTON, G TIMOTHY | Director | 3800 AIRPORT BOULEVARDMOBILE, AL 36608 |
| CHRISTIANSON, CLARK P | Director | 6801 AIRPORT BOULEVARDMOBILE, AL 36608 |
| ROUSE, BETH MCFADDEN | Director | 718 DOWNTOWNER BOULEVARDMOBILE, AL 36609 |
| IQBAL, IJAZ | Director | 6801 AIRPORT BOULEVARDMOBILE, AL 36608 |
| MYERS, THOMAS | Director | 6701 AIRPORT BOULEVARD #A-101MOBILE, AL 36608 |
| GANGLE, THOMAS A | Director | 20 KINGSWAYMOBILE, AL 36608 |
| PINKERT, CHARLES | Director | 6701 AIRPORT BOULEVARD D-241MOBILE, AL 36608 |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY INC | Agent | 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808 |
| Name | Role | Address |
|---|---|---|
| WADDELL, ADINE B | Incorporator | 6801 AIRPORT BOULEVARDMOBILE, AL 36608 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
