| Name: | Great State 2019 Inc |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Non-Profit Corporation |
| Status: | Exists |
| Date of registration: | 18 Apr 2017 (8 years ago) |
| Entity Number: | 000-833-120 |
| Register Number: | 000833120 |
| County: | Tuscaloosa |
| Place of Formation: | Delaware |
| Principal Address: | 4960 Rice Mine Road NE Suite30-ATuscaloosa, AL 35406 |
| Principal Address ZIP Code: | 35406 |
| Registered Office Street Address: | 4960 Rice Mine Road NE Suite 30-ATuscaloosa, AL 35406 |
| Registered Office Street Address ZIP Code: | 35406 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124757588 | 2022-06-09 | 2022-06-09 | 4960 RICE MINE RD NE STE 30A, TUSCALOOSA, AL, 354063136, US | 4960 RICE MINE RD NE STE 30A, TUSCALOOSA, AL, 354063136, US | |||||||||||||
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| Phone | +1 205-509-9055 |
Authorized person
| Name | DANIEL SPARKMAN |
| Role | EXECUTIVE DIRECTOR |
| Phone | 2055099055 |
Taxonomy
| Taxonomy Code | 207N00000X - Dermatology Physician |
| Is Primary | Yes |
| Name | Role |
|---|---|
| Bentley, Robert | Agent |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
