| Name: | West Alabama Pain Management, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 27 Jul 2004 (20 years ago) |
| Date of dissolution: | 16 Feb 2018 |
| Entity Number: | 000-453-677 |
| Register Number: | 000453677 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Principal Address: | COTTONDALE, AL |
| Registered Office Street Address: | 9858 KEENES MILL RDCOTTONDALE, AL 35453 |
| Registered Office Street Address ZIP Code: | 35453 |
Activities
PROVIDE MEDICAL/REHABILITATION CARE FOR CHRONIC PAIN PATIENTS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225214018 | 2008-01-11 | 2008-01-11 | 1321 MCFARLAND BLVD E, TUSCALOOSA, AL, 354043839, US | 1321 MCFARLAND BLVD E, TUSCALOOSA, AL, 354043839, US | |||||||||||||||||||||||||
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| Phone | +1 205-758-1833 |
| Fax | 2057588880 |
Authorized person
| Name | DR. RAMA D PIDIKITI |
| Role | PHYSICIAN |
| Phone | 2057581833 |
Taxonomy
| Taxonomy Code | 305R00000X - Preferred Provider Organization |
| License Number | MD.13295 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | INDIVIDUAL NPI # |
| Number | 1508881335 |
| State | AL |
| Name | Role |
|---|---|
| PIDIKITI, RAMA DEVI | Member |
| Name | Role |
|---|---|
| PIDIKITI, RAMA DEVI | Agent |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
