| Name: | Dr. Tom Conboy, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 05 May 2014 (11 years ago) (Companies founded in May 2014) |
| Entity Number: | 000-309-121 |
| Register Number: | 000309121 |
| ZIP code: | 36867 (Companies in Russell, 36867) |
| County: | Russell |
| Place of Formation: | Jefferson County |
| Principal Address: | 1200 14TH STREETPHENIX CITY, AL 36867 |
| Principal Mailing Address: | 26 WICKHAM DRCOLUMBUS, GA 31907 |
| Registered Office Mailing Address: | PO BOX 321274BIRMINGHAM, AL 35212 |
| Registered Office Street Address: | 5607 1ST AVENUE SOUTHBIRMINGHAM, AL 35212 |
| Authorized Capital: | 1000 @ 1.00 PV |
Activities
PROFESSIONAL MEDICAL
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417367962 | 2014-05-06 | 2014-05-14 | 1200 14TH ST, SUITE A, PHENIX CITY, AL, 368674907, US | 1200 14TH ST, SUITE A, PHENIX CITY, AL, 368674907, US | |||||||||||||||||||||||||
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| Phone | +1 205-821-1607 |
Authorized person
| Name | DR. THOMAS JOSEPH CONBOY |
| Role | PRESIDENT |
| Phone | 2058211607 |
Taxonomy
| Taxonomy Code | 261QM0850X - Adult Mental Health Clinic/Center |
| License Number | 555 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 261QM0855X - Adolescent and Children Mental Health Clinic/Center |
| License Number | 555 |
| State | AL |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| CONBOY, TOM | Director | 26 WICKHAM DRCOLUMBUS, GA 31907 |
| Name | Role | Address |
|---|---|---|
| CONBOY, TOM | Incorporator | 26 WICKHAM DRCOLUMBUS, GA 31907 |
| Name | Role |
|---|---|
| VINES, GERALD JR | Agent |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
