| Name: | PrevMed Alabama, PC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 26 Mar 2021 (4 years ago) |
| Entity Number: | 000-843-216 |
| Register Number: | 000843216 |
| County: | Baldwin |
| Place of Formation: | Montgomery County |
| Registered Office Street Address: | 30762 STATE HWY 181SPANISH FORT, AL 36527 |
| Registered Office Street Address ZIP Code: | 36527 |
| Principal Address: | 1851 N MCKENZIE STREET STE 106FOLEY, AL 36535 |
| Principal Address ZIP Code: | 36535 |
| Authorized Capital: | 10000@$1.00PV |
Activities
TO ENGAGE IN THE PROFESSION OF MEDICINE & SERVICES RELATED THERE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1487228425 | 2021-05-14 | 2021-07-27 | 30762 STATE HIGHWAY 181, SPANISH FORT, AL, 365275672, US | 30762 STATE HIGHWAY 181, SPANISH FORT, AL, 365275672, US | |||||||||||||||||||||||||||
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| Phone | +1 251-444-1999 |
| Fax | 2514441998 |
| Phone | +1 251-450-3700 |
| Fax | 2512636333 |
Authorized person
| Name | THOMAS FORDHAM BREWER |
| Role | PROVIDER |
| Phone | 2514503700 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 2083P0500X - Preventive Medicine/Occupational Environmental Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 2083X0100X - Occupational Medicine Physician |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| BREWER, THOMAS F MD | Incorporator | 3234 BEACON STREETLEXINGTON, KY 40513 |
| Name | Role |
|---|---|
| JUBILEE HEALTH PARTNERS LLC | Agent |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
