| Name: | Tracey L. Mercer, OD, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 26 Sep 2014 (10 years ago) |
| Entity Number: | 000-319-145 |
| Register Number: | 000319145 |
| County: | Shelby |
| Place of Formation: | Shelby County |
| Registered Office Street Address: | 191 CHASE DRIVEPELHAM, AL 35214 |
| Registered Office Street Address ZIP Code: | 35214 |
| Principal Address: | 191 CHASE DRIVEPELHAM, AL 35124 |
| Principal Address ZIP Code: | 35124 |
| Authorized Capital: | 1000 @ $1.00PV |
Activities
OPTOMETRY PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528464799 | 2014-11-14 | 2014-11-14 | 2000 SOUTHLAKE PARK, SUITE 100, HOOVER, AL, 352443616, US | 2000 SOUTHLAKE PARK, SUITE 100, HOOVER, AL, 352443616, US | |||||||||||||||||||||||||
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| Phone | +1 205-968-1160 |
| Fax | 2059681159 |
Authorized person
| Name | DR. TRACEY LYNN MERCER |
| Role | OWNER/ OPTOMETRIST |
| Phone | 2059681160 |
Taxonomy
| Taxonomy Code | 152W00000X - Optometrist |
| License Number | S938TA511 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 0515-04336 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| MERCER, TRACEY L | Agent | 191 CHASE DRIVEPELHAM, AL 35124 |
| Name | Role | Address |
|---|---|---|
| MERCER, TRACEY L | Director | 191 CHASE DRIVEPELHAM, AL 35124 |
| Name | Role | Address |
|---|---|---|
| MERCER, TRACEY L | Incorporator | 191 CHASE DRIVEPELHAM, AL 35124 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
