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IMC-Central Baldwin Physicians, LLC

Details

Name: IMC-Central Baldwin Physicians, LLC
Jurisdiction: Alabama
Legal type: Domestic Professional Limited Liability Company
Status: Exists
Date of registration: 22 Apr 2016 (9 years ago) (Companies founded in April 2016)
Entity Number: 000-361-797
Register Number: 000361797
Historical Names: IMC-Central Baldwin Physicians, P.C.
ZIP code: 36604 (Companies in Mobile, 36604)
County: Mobile
Place of Formation: Mobile County
Registered Office Street Address: 5 MOBILE INFIRMARY CIRCLEMOBILE, AL 36607
Principal Address: 1700 SPRINGHILL AVENUEMOBILE, AL 36604
Principal Mailing Address: PO BOX 2226MOBILE, AL 36652

Activities PROFESSIONAL MEDICAL SERVICES & SERVICES ANCILLARY THERETO

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1346697539 2016-05-18 2019-08-26 18317 US 90, ROBERTSDALE, AL, 36567, US 18317 US 90, ROBERTSDALE, AL, 36567, US

Contacts

Phone +1 251-947-2000

Authorized person

Name MR. ANTHONY PALAZZO
Role VP OF FINANCE
Phone 2514351361

Taxonomy

Taxonomy Code 207Q00000X - Family Medicine Physician
Is Primary No
Taxonomy Code 207R00000X - Internal Medicine Physician
Is Primary Yes

Agent

Name Role
NIX, D M Agent

Events

Event Date Event Type Old Value New Value
2017-03-24 Name Change IMC-Central Baldwin Physicians, P.C. IMC-Central Baldwin Physicians, LLC

Date of last update: 03 Aug 2024

Sources: Alabama Secretary of State