| Name: | Dr. Tamara McIntosh, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 23 Aug 2006 (18 years ago) |
| Entity Number: | 000-483-207 |
| Register Number: | 000483207 |
| County: | Calhoun |
| Place of Formation: | Calhoun County |
| Principal Address: | OHATCHEE, AL |
| Registered Office Street Address: | 1414 ALABAMA HWY 144OHATCHEE, AL 36271 |
| Registered Office Street Address ZIP Code: | 36271 |
Activities
MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467549147 | 2006-10-06 | 2008-04-20 | 1410 AL HWY 144, OHATCHEE, AL, 362717887, US | 1410 AL HIGHWAY 144, OHATCHEE, AL, 362717887, US | |||||||||||||||||||||||||
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| Phone | +1 256-892-2121 |
| Fax | 2568923733 |
Authorized person
| Name | TAMARA MCINTOSH |
| Role | OWNER PHYSICIAN |
| Phone | 2568922121 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 20130 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 51538228 |
| State | AL |
| Name | Role |
|---|---|
| MCINTOSH, TAMARA | Agent |
| Name | Role |
|---|---|
| MCINTOSH, TAMARA | Member |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
