| Name: | University of South Alabama Health Care Authority |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Public Corporation |
| Status: | Exists |
| Date of registration: | 02 May 2017 (8 years ago) |
| Entity Number: | 000-390-134 |
| Register Number: | 000390134 |
| County: | Mobile |
| Place of Formation: | Alabama |
| Principal Address: | 307 UNIVERSITY BLVD N AD 170MOBILE, AL 36688-0002 |
| Registered Office Street Address: | 307 UNIVERSITY BLVD N ROOM 140MOBILE, AL 36688 |
| Registered Office Street Address ZIP Code: | 36688 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598339186 | 2021-05-18 | 2021-05-18 | 3929-1 AIRPORT BLVD, 5TH FLOOR ROOM 513, MOBILE, AL, 36609, US | 1601 CENTER ST, MOBILE, AL, 366041541, US | |||||||||||||||||||
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| Phone | +1 251-318-2681 |
| Fax | 2513786222 |
| Phone | +1 251-434-3475 |
| Fax | 2514343837 |
Authorized person
| Name | ERICA MADISON |
| Role | CREDENTIALING |
| Phone | 2513182681 |
Taxonomy
| Taxonomy Code | 261QM1300X - Multi-Specialty Clinic/Center |
| Is Primary | Yes |
| Name | Role |
|---|---|
| KRISTIN DANIELS DUKES | Agent |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
