| Name: | Foley Family Practice Management, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 18 Aug 2015 (9 years ago) |
| Entity Number: | 000-343-041 |
| Register Number: | 000343041 |
| County: | Baldwin |
| Place of Formation: | Baldwin County |
| Registered Office Street Address: | 205 WEST ORANGE AVEFOLEY, AL 36535 |
| Registered Office Street Address ZIP Code: | 36535 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083080600 | 2015-08-18 | 2015-08-18 | 205 W ORANGE AVE, FOLEY, AL, 365351905, US | 205 W ORANGE AVE, FOLEY, AL, 365351905, US | |||||||||||||||
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| Phone | +1 251-943-6108 |
| Fax | 2519436108 |
Authorized person
| Name | TARA A WAITE |
| Role | OWNER |
| Phone | 2055227000 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WAITE, TARA | Agent | 1408 OLD PINEYWOODS RDJASPER, AL 35504 |
| Name | Role | Address |
|---|---|---|
| PORTER, DIANE M | Organizer | 15213 HWY 59 NORTH SUITE #100FOLEY, AL 36535 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
