| Name: | Central Alabama Foot Care, L.L.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 10 Jun 2002 (22 years ago) |
| Entity Number: | 000-682-955 |
| Register Number: | 000682955 |
| County: | Elmore |
| Place of Formation: | Elmore County |
| Principal Address: | TALLASSEE, AL |
| Registered Office Street Address: | 875 FRIENDSHIP RDTALLASSEE, AL 36078 |
| Registered Office Street Address ZIP Code: | 36078 |
Activities
PROVIDE PROFESSIONAL PODIATRIC/MEDICAL/SURGICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1841468238 | 2008-02-19 | 2008-07-29 | PO BOX 780367, TALLASSEE, AL, 360780004, US | 875 FRIENDSHIP RD, SUITE J, TALLASSEE, AL, 360781234, US | |||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 334-283-4178 |
| Fax | 3342832190 |
Authorized person
| Name | MS. LYNNE B EADY |
| Role | OFFICE MANAGER |
| Phone | 3342834178 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 71 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 515-12528 |
| Issuer | MEDICAID |
| Number | 051552056 |
| State | AL |
| Issuer | MEDICARE GROUP |
| Number | J027 |
| State | AL |
| Issuer | MEDICAID GROUP |
| Number | 529914900 |
| State | AL |
| Name | Role |
|---|---|
| DUBAY, GREGORY V | Agent |
| Name | Role |
|---|---|
| DUBAY, GREGORY V | Member |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
