| Name: | Pickens County Primary Care, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 07 Jan 2014 (11 years ago) |
| Entity Number: | 000-294-378 |
| Register Number: | 000294378 |
| County: | Pickens |
| Place of Formation: | Tuscaloosa County |
| Registered Office Street Address: | 108 4TH AVENUE SW, SUITE AREFORM, AL 35481 |
| Registered Office Street Address ZIP Code: | 35481 |
| Authorized Capital: | 1000 @ $1.00 PV |
Activities
PRACTICE OF MEDICINE & PROVIDING MEDICAL SERVICES
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EB3BDFEWXSJ9 | 2024-02-27 | 108 4TH AVE SW, STE A, REFORM, AL, 35481, 8018, USA | P O BOX 1000, REFORM, AL, 35481, 1000, USA | |||||||||||||||||||||||||||||||||||||||||||
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| URL | www.pc3med.com |
| Division Name | PICKENS COUNTY PRIMARY CARE |
| Congressional District | 07 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2023-03-01 |
| Initial Registration Date | 2017-07-30 |
| Entity Start Date | 2014-07-01 |
| Fiscal Year End Close Date | Dec 16 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | REGINA A BEAMS |
| Role | PRACTICE MANAGER |
| Address | P O BOX 1000, REFORM, AL, 35481, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | REGINA A BEAMS |
| Role | PRACTICE MANAGER |
| Address | P O BOX 1000, REFORM, AL, 35481, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295421667 | 2023-04-17 | 2023-07-11 | PO BOX 1000, REFORM, AL, 354811000, US | 535 4TH ST NW, GORDO, AL, 354662558, US | |||||||||||||||||
|
|||||||||||||||||||||
| Phone | +1 205-656-4872 |
Authorized person
| Name | JULIA L BOOTHE |
| Role | OWNER |
| Phone | 2057926702 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 261QR1300X - Rural Health Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BOOTHE, JULIA | Agent | 14670 BEL AIRE ESTATECOKER, AL 35452 |
| Name | Role | Address |
|---|---|---|
| BOOTHE, JULIA | Director | 14670 BEL AIRE ESTATECOKER, AL 35452 |
| Name | Role | Address |
|---|---|---|
| BOOTHE, JULIA | Incorporator | 14670 BEL AIRE ESTATECOKER, AL 35452 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
