| Name: | LIBERTY MOUNTAIN PEDIATRICS, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 12 Jun 2018 (6 years ago) |
| Entity Number: | 000-521-800 |
| Register Number: | 000521800 |
| County: | Shelby |
| Place of Formation: | Shelby County |
| Principal Address: | 2504 INVERNESS LANDINGBIRMINGHAM, AL 35242 |
| Principal Address ZIP Code: | 35242 |
| Authorized Capital: | 1,000 @ $1/PV |
Activities
OPERATE MEDICAL PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487133898 | 2018-08-08 | 2018-08-08 | 4600 HIGHWAY 280, BIRMINGHAM, AL, 352425028, US | 4600 HIGHWAY 280, BIRMINGHAM, AL, 352425028, US | |||||||||||||
|
|||||||||||||||||
| Phone | +1 205-790-1650 |
Authorized person
| Name | GREGG WILLIAM THOMAS |
| Role | ADMINISTRATOR |
| Phone | 2057091650 |
Taxonomy
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| BYARS, ANNE | Agent | 2504 INVERNESS LANDINGBIRMINGHAM, AL 35242 |
| Name | Role | Address |
|---|---|---|
| BYARS, ANNE | Director | 2504 INVERNESS LANDINGBIRMINGHAM, AL 35242 |
| Name | Role | Address |
|---|---|---|
| GENTLE, EDGAR C III | Incorporator | 501 RIVERCHASE PARKWAY EAST STE 100HOOVER, AL 35244 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
