Name: | West Alabama Physician Associates, LLC |
Jurisdiction: | Alabama |
Legal type: | Domestic Limited Liability Company |
Status: | Exists |
Date of registration: | 24 Jun 2008 (16 years ago) |
Entity Number: | 000-421-975 |
Register Number: | 000421975 |
County: | Tuscaloosa |
Place of Formation: | Tuscaloosa County |
Registered Office Street Address: | 3901 GREENSBORO AVE., SUITE ATUSCALOOSA, AL 35405 |
Registered Office Street Address ZIP Code: | 35405 |
Activities
PHYSICIAN HEALTH CARE SERVICES
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1104668417 | 2024-06-07 | 2024-06-20 | 3901 GREENSBORO AVE STE A, TUSCALOOSA, AL, 354053771, US | 701 UNIVERSITY BLVD E STE 204, TUSCALOOSA, AL, 354017431, US | |||||||||||||
|
Phone | +1 205-759-6165 |
Authorized person
Name | DANIEL CLAY CONVILLE |
Role | CORP DIRECTOR, PHYSICIAN SERVICES |
Phone | 2057596165 |
Taxonomy
Taxonomy Code | 207RI0200X - Infectious Disease Physician |
Is Primary | Yes |
Name | Role |
---|---|
DANIEL CONVILLE | Agent |
Name | Role | Address |
---|---|---|
DCH HEALTH CARE AUTHORITY | Member | 809 UNIVERSITY BOULEVARD EASTTUSCALOOSA, AL 35401 |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State