| Name: | Care Network of East Alabama, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Exists |
| Date of registration: | 12 Jan 2011 (14 years ago) |
| Entity Number: | 000-572-769 |
| Register Number: | 000572769 |
| County: | Lee |
| Place of Formation: | Lee County |
| Principal Address: | OPELIKA, AL |
| Registered Office Street Address: | 2000 PEPPERELL PKWYOPELIKA, AL 36801 |
| Registered Office Street Address ZIP Code: | 36801 |
Activities
PROVIDE PRIMARY/PREVENTATIVE HEALTH SERVICES TO THE UNDERINSURED
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1568754737 | 2011-05-06 | 2011-05-26 | 1365 GATEWOOD DR, SUITE 521, AUBURN, AL, 368302834, US | 1365 GATEWOOD DR, SUITE 521, AUBURN, AL, 368302834, US | |||||||||||||||||||||
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| Phone | +1 334-528-5867 |
| Fax | 3345281195 |
Authorized person
| Name | DR. MICHAEL J. LISENBY |
| Role | VICE CHAIRMAN OF THE BOARD |
| Phone | 3345285981 |
Taxonomy
| Taxonomy Code | 251B00000X - Case Management Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MISCELLANEOUS PROVIDER |
| Number | 999 |
| State | AL |
| CAGE number | Status | Type | Established | CAGE Update Date | CAGE Expiration | SAM Expiration | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 71SB0 | Active | Non-Manufacturer | 2014-01-21 | 2016-01-02 | No data | No data | |||||||||||||
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| POC | KIM EASON |
| Phone | +1 334-528-5867 |
| Address | 1365 GATEWOOD DR STE 521, AUBURN, LEE, AL, 36830 2834, UNITED STATES |
Ownership of Offeror Information
| Highest Level Owner | Information not Available |
|---|
| Immediate Level Owner | Information not Available |
|---|
| List of Offerors (0) | Information not Available |
|---|
| Name | Role |
|---|---|
| NUTTER, ROBEN H | Agent |
| Name | Role | Address |
|---|---|---|
| LISENBY, MICHAEL J | Incorporator | 2000 PEPPERELL PKWYOPELIKA, AL 36801 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
