| Name: | Primary Care Pediatrics and Family Medicine, PC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 04 Mar 2015 (10 years ago) |
| Entity Number: | 000-330-141 |
| Register Number: | 000330141 |
| Historical Names: |
Primary Care Pediatrics, PC
|
| County: | Limestone |
| Place of Formation: | Madison County |
| Registered Office Street Address: | 147 CASTLEWOOD DRIVEMADISON, AL 35756 |
| Registered Office Street Address ZIP Code: | 35756 |
| Authorized Capital: | 10000 @ $1.00PV |
Activities
PROFESSIONAL MEDICAL AND OTHER HEALTH RELATED SERVICES TO PUBLIC
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083078596 | 2016-04-11 | 2016-09-02 | PO BOX 269, CAPSHAW, AL, 357420269, US | 29869 CAPSHAW ROAD, HARVEST, AL, 35749, US | |||||||||||||||||||
|
|||||||||||||||||||||||
| Phone | +1 256-262-1040 |
| Fax | 2563252180 |
Authorized person
| Name | DR. SHRADDHA SHRESTHA |
| Role | CEO |
| Phone | 2564253668 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| SHRESTHA, SHRADDHA | Agent | 147 CASTLEWOOD DRIVEMADISON, AL 35756 |
| Name | Role | Address |
|---|---|---|
| SHRESTHA, SHRADDRA | Director | 147 CASTLEWOOD DRIVEMADISON, AL 35756 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2015-08-24 | Name Change | Primary Care Pediatrics, PC | Primary Care Pediatrics and Family Medicine, PC |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
