| Name: | Tuscaloosa Geriatrics, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 16 Jul 2014 (10 years ago) |
| Date of dissolution: | 28 Dec 2023 |
| Entity Number: | 000-313-847 |
| Register Number: | 000313847 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Registered Office Street Address: | 4000 CAROUSEL CIRCLETUSCALOOSA, AL 35406 |
| Registered Office Street Address ZIP Code: | 35406 |
| Authorized Capital: | 5000 @ $1.00PV |
Activities
PRACTICE OF MEDICINE AND SERVICES ANCILLARY THERETO
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649687179 | 2014-07-16 | 2014-07-16 | PO BOX 20335, TUSCALOOSA, AL, 354020335, US | 4000 CAROUSEL CIR, TUSCALOOSA, AL, 354062997, US | |||||||||||||||||
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| Phone | +1 205-657-0711 |
Authorized person
| Name | DR. REGINA HARRELL |
| Role | GERIATRICIAN |
| Phone | 2056570711 |
Taxonomy
| Taxonomy Code | 207RG0300X - Geriatric Medicine (Internal Medicine) Physician |
| License Number | 27429 |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| HARRELL, REGINA | Director | 4000 CAROUSEL CIRCLETUSCALOOSA, AL 35406 |
| Name | Role | Address |
|---|---|---|
| HARRRELL, REGINA | Incorporator | 4000 CAROUSEL CIRCLETUSCALOOSA, AL 35406 |
| Name | Role | Address |
|---|---|---|
| HARRRELL, REGINA | Agent | 4000 CAROUSEL CIRCLETUSCALOOSA, AL 35406 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
