| Name: | NORTH JEFFERSON PEDIATRICS, INC. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 24 Mar 2014 (11 years ago) |
| Entity Number: | 000-299-912 |
| Register Number: | 000299912 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 1326 MAIN STREET SUITE 124GARDENDALE, AL 35071 |
| Registered Office Street Address ZIP Code: | 35071 |
| Authorized Capital: | 1000 @ $1.00 PV |
Activities
PEDIATRIC AND GENERAL MEDICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104012137 | 2007-09-24 | 2018-06-16 | PO BOX 952, GARDENDALE, AL, 350710952, US | 934 GRUBBS AVE, GARDENDALE, AL, 350712637, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 205-608-1222 |
| Fax | 2056083848 |
| Phone | +1 205-608-1233 |
Authorized person
| Name | DR. FADELL N SAVANY |
| Role | DOCTOR |
| Phone | 2056081233 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | 17781 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | VIVA |
| Number | F93530 |
| State | AL |
| Issuer | MEDICAID |
| Number | 529900190 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| SAVANY, FADELL N | Agent | 1326 MAIN STREET SUITE 124GARDENDALE, AL 35071 |
| Name | Role | Address |
|---|---|---|
| SAVANY, FADELL NASSER | Director | 1326 MAIN STREET SUITE 124GARDENDALE, AL 35071 |
| Name | Role | Address |
|---|---|---|
| SAVANY, FADELL N | Incorporator | 1326 MAIN STREET SUITE 124GARDENDALE, AL 35071 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
