| Name: | Shelby-Chilton Hematology and Oncology, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 17 Dec 2010 (14 years ago) |
| Entity Number: | 000-305-233 |
| Register Number: | 000305233 |
| County: | Chilton |
| Place of Formation: | Chilton County |
| Principal Address: | CLANTON, AL |
| Registered Office Street Address: | 50 HEALTH CENTER DRIVECLANTON, AL 35045 |
| Registered Office Street Address ZIP Code: | 35045 |
Activities
MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093018681 | 2010-12-21 | 2014-05-06 | PO BOX 113, PELHAM, AL, 351240113, US | 644 2ND ST NE STE 202, ALABASTER, AL, 350078823, US | |||||||||||||||||||||
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| Phone | +1 205-358-3321 |
| Fax | 2053583322 |
| Phone | +1 205-563-3583 |
Authorized person
| Name | DR. BALAGANESH GOPURALA |
| Role | OWNER |
| Phone | 2053583321 |
Taxonomy
| Taxonomy Code | 207RH0003X - Hematology & Oncology Physician |
| License Number | 24965 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GOPURALA, BALA G | Agent | 5228 CLAIRMONT AVE SBIRMINGHAM, AL 35222 |
| Name | Role | Address |
|---|---|---|
| GOPURALA, BALA G | Member | 5228 CLAIRMONT AVE SBIRMINGHAM, AL 35222 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
