| Name: | Coosa Pain and Wellness, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 18 Feb 2013 (12 years ago) (Companies founded in February 2013) |
| Date of dissolution: | 15 Sep 2022 |
| Entity Number: | 000-276-973 |
| Register Number: | 000276973 |
| ZIP code: | 35901 (Companies in Etowah, 35901) |
| County: | Etowah |
| Place of Formation: | Etowah County |
| Principal Address: | 100 WILSON STREETGADSDEN, AL 35901 |
| Authorized Capital: | 10,000,000 |
Activities
PRACTICE OF MEDICINE
ANETHESIA SERVICES AND PAIN MANAGEMENT
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093147951 | 2013-08-02 | 2018-06-22 | PO BOX 266, GADSDEN, AL, 359020266, US | 3804 RAINBOW DR, RAINBOW CITY, AL, 359063051, US | |||||||||||||||||
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| Phone | +1 256-442-6181 |
| Phone | +1 256-952-2200 |
| Fax | 2569522202 |
Authorized person
| Name | THOMAS KEVIN LACKEY |
| Role | OWNER |
| Phone | 2564426181 |
Taxonomy
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| LACKEY, THOMAS K | Agent | 100 WILSON DRIVEGADSDEN, AL 35901 |
| Name | Role | Address |
|---|---|---|
| LACKEY, THOMAS K | Incorporator | 100 WILSON DRIVEGADSDEN, AL 35901 |
| Name | Role | Address |
|---|---|---|
| LACKEY, THOMAS K | Director | 100 WILSON DRIVEGADSDEN, AL 35901 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
