| Name: | Baptist South ED Observation Unit, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 21 Apr 2021 (4 years ago) |
| Date of dissolution: | 24 Sep 2024 |
| Entity Number: | 000-848-377 |
| Register Number: | 000848377 |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Principal Address: | 265 BROOKVIEW CENTRE WAY STE 400KNOXVILLE, TN 37919 |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
| Registered Office Street Address ZIP Code: | 36104 |
| Authorized Capital: | 1000@$NPV |
Activities
MEDICAL STAFFING & THE TRANSACTION OF ANY LAWFUL BUSINESS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174191522 | 2021-06-14 | 2021-06-14 | 1643 NW 136TH AVE STE 100, SUNRISE, FL, 333232857, US | 2105 E SOUTH BLVD, MONTGOMERY, AL, 361162409, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 800-424-3672 |
| Fax | 9543773042 |
| Phone | +1 334-288-2100 |
Authorized person
| Name | DR. RANDAL L DBBS |
| Role | PRESIDEMT |
| Phone | 8652935210 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 208M00000X - Hospitalist Physician |
| Is Primary | Yes |
| Taxonomy Code | 363A00000X - Physician Assistant |
| Is Primary | No |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY INC | Agent | 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808 |
| Name | Role | Address |
|---|---|---|
| DABBS, RANDAL | Director | 265 BROOKVIEW CENTRE WAY STE 400KNOXVILLE, TN 37919 |
| Name | Role | Address |
|---|---|---|
| STAIR, JOHN R | Incorporator | 265 BROOKVIEW CENTRE WAY STE 400KNOXVILLE, TN 37919 |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
