| Name: | OPELIKA PEDIATRICS & FAMILY CLINIC PC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 14 Aug 2014 (10 years ago) (Companies founded in August 2014) |
| Entity Number: | 000-315-941 |
| Register Number: | 000315941 |
| ZIP code: | 36804 (Companies in Lee, 36804) |
| County: | Lee |
| Place of Formation: | Lee County |
| Principal Address: | 5809 HWY 280 EASTOPELIKA, AL 36804 |
| Principal Mailing Address: | 3700 SOUTH RAILROAD STREET STE APHENIX CITY, AL 36867 |
| Registered Office Street Address: | 1415 FALL BRANCH DRIVEPHENIX CITY, AL 36867 |
| Authorized Capital: | 100 @ NPV |
Activities
OWN/OPERATE MEDICAL CLINIC
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| VV9WWZQMNPF7 | 2025-02-11 | 5809 US HIGHWAY 280 E, OPELIKA, AL, 36804, 8515, USA | 3700 SOUTH RAILROAD ST, A, PHENIX CITY, AL, 36867, USA | |||||||||||||||||||||||||||||||||||||||||
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| Congressional District | 03 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2024-02-27 |
| Initial Registration Date | 2021-06-17 |
| Entity Start Date | 2015-10-17 |
| Fiscal Year End Close Date | Dec 31 |
Service Classifications
| NAICS Codes | 621111 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | RAJIV SRIVASTAVA |
| Role | ADMINISTRATOR |
| Address | 3700 SOUTH RAILROAD ST, PHENIX CITY, AL, 36867, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | RAJIV SRIVASTAVA |
| Role | ADMINISTRATOR |
| Address | 3700 SOUTH RAILROAD ST, PHENIX CITY, AL, 36867, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306240502 | 2014-10-16 | 2017-06-09 | 3700 S RAILROAD ST STE A, PHENIX CITY, AL, 368672994, US | 5809 HWY 280E, OPELIKA, AL, 36804, US | |||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 334-664-0463 |
| Fax | 3346640466 |
| Phone | +1 334-705-6966 |
Authorized person
| Name | DR. RITU CHANDRA |
| Role | PRESIDENT |
| Phone | 3346640463 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 207QA0505X - Adult Medicine Physician |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 207QG0300X - Geriatric Medicine (Family Medicine) Physician |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 208000000X - Pediatrics Physician |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 208D00000X - General Practice Physician |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Name | Role |
|---|---|
| SRIVASTAVA, RAJIV | Agent |
| Name | Role | Address |
|---|---|---|
| CHANDRA, RITU | Director | 1415 FALL BRANCH DRIVEPHENIX CITY, AL 36867 |
| Name | Role | Address |
|---|---|---|
| CHANDRA, RITU | Incorporator | 1415 FALL BRANCH DRIVEPHENIX CITY, AL 36867 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
