| Name: | Madison MedNorth Primary Care PC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 12 Mar 2019 (6 years ago) |
| Entity Number: | 000-546-559 |
| Register Number: | 000546559 |
| County: | Madison |
| Place of Formation: | Madison County |
| Registered Office Street Address: | 101 WESTOVER CIRCLE STE AMADISON, AL 35758 |
| Registered Office Street Address ZIP Code: | 35758 |
| Authorized Capital: | 1000 @ $1.00 PV |
Activities
ANY LAWFUL BUSINESS
ACT OR ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659838456 | 2019-02-27 | 2019-02-27 | 17449 CARILLON DR, ATHENS, AL, 356110617, US | 101 WESTOVER CIR, MADISON, AL, 357584909, US | |||||||||||||
|
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| Phone | +1 256-278-9731 |
Authorized person
| Name | DR. ROMUALDO ENRIQUE DIAZ |
| Role | PRESIDENT |
| Phone | 2562789731 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DIAZ, ROMUALDO ENRIQUE | Director | 17449 CARILLON DRIVEATHENS, AL 35611 |
| Name | Role | Address |
|---|---|---|
| BURNEY, L J | Incorporator | 655 GALLATIN ST SWHUNTSVILLE, AL 35801 |
| Name | Role |
|---|---|
| DIAZ, ROMUALDO E | Agent |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
