Name: | Pediatric Associates of Decatur, L.L.C. |
Jurisdiction: | Alabama |
Legal type: | Domestic Limited Liability Company |
Status: | Exists |
Date of registration: | 05 Aug 2009 (15 years ago) |
Entity Number: | 000-436-716 |
Register Number: | 000436716 |
County: | Madison |
Place of Formation: | Madison County |
Principal Address: | HUNTSVILLE, AL |
Registered Office Street Address: | 2430 L&N DRHUNTSVILLE, AL 35801 |
Registered Office Street Address ZIP Code: | 35801 |
Activities
MEDICAL PRACTICE
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1699908673 | 2009-08-25 | 2009-08-25 | 1874 BELTLINE RD SW, SUITE 160, DECATUR, AL, 356015514, US | 1874 BELTLINE RD SW, SUITE 160, DECATUR, AL, 356015514, US | |||||||||||||||||||
|
Phone | +1 256-306-9400 |
Fax | 2563069896 |
Authorized person
Name | SUSHIL S VALAVALKAR |
Role | PHYSICIAN/OWNER |
Phone | 2563069400 |
Taxonomy
Taxonomy Code | 208000000X - Pediatrics Physician |
License Number | MD29718 |
State | AL |
Is Primary | Yes |
Name | Role |
---|---|
GAMONS, ROBERT C | Agent |
Name | Role |
---|---|
VALAVALKAR, SUBHASHINI | Member |
VALAVALKAR, SUSHIL S | Member |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State