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Rocky Ridge Family Medicine, LLC

Details

Name: Rocky Ridge Family Medicine, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 09 Dec 2003 (21 years ago)
Entity Number: 000-695-557
Register Number: 000695557
County: Jefferson
Place of Formation: Jefferson County
Principal Address: BIRMINGHAM, AL
Registered Office Street Address: 2470 ROCKY RIDGE RDBIRMINGHAM, AL 35243
Registered Office Street Address ZIP Code: 35243

Activities FAMILY MEDICINE PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1245266378 2006-06-23 2020-08-22 2470 ROCKY RIDGE RD, STE 200, BIRMINGHAM, AL, 352432833, US 2470 ROCKY RIDGE RD, STE 200, BIRMINGHAM, AL, 352432833, US

Contacts

Phone +1 205-823-1899
Fax 2058239369

Authorized person

Name JUDY A CAMPODONICO
Role DIRECTOR OF OPERATIONS
Phone 2058798294

Taxonomy

Taxonomy Code 207Q00000X - Family Medicine Physician
Is Primary Yes

Agent

Name Role
CHANDLER, MICHAEL A Agent

Member

Name Role
CHANDLER, MICHAEL A Member

Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State