| Name: | Paragon Contracting Services, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Limited Liability Company |
| Status: | Exists |
| Date of registration: | 30 Nov 1995 (29 years ago) |
| Entity Number: | 000-922-466 |
| Register Number: | 000922466 |
| Historical Names: |
Paragon Contracting Services, Inc.
|
| County: | Montgomery |
| Place of Formation: | Florida |
| Principal Address: | 5870 NORTH HIATUS ROAD, SUITE 200TAMARAC, FL 33321 |
| Principal Mailing Address: | 265 BROOKVIEW CENTRE WAY, SUITE 400KNOXVILLE, TN 37919 |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
| Registered Office Street Address ZIP Code: | 36104 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225071459 | 2006-06-14 | 2020-09-04 | PO BOX 634710, CINCINNATI, OH, 452634710, US | 810 SAINT VINCENTS DR, BIRMINGHAM, AL, 352051601, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 800-424-3672 |
| Fax | 9543773042 |
| Phone | +1 205-939-7100 |
Authorized person
| Name | DR. MICHAEL D. CORVINI |
| Role | PRESIDENT |
| Phone | 8004243672 |
Taxonomy
| Taxonomy Code | 207P00000X - Emergency Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 208000000X - Pediatrics Physician |
| Is Primary | No |
| Taxonomy Code | 2080P0204X - Pediatric Emergency Medicine (Pediatrics) Physician |
| Is Primary | No |
| Taxonomy Code | 363A00000X - Physician Assistant |
| Is Primary | No |
| Taxonomy Code | 363L00000X - Nurse Practitioner |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICARE TRAVELERS RR - G |
| Number | DC7358 |
| Issuer | MEDICAID |
| Number | 529922030 |
| State | AL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | F962 |
| State | AL |
| Issuer | MEDICAID |
| Number | 105831 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| CORPORATION SERVICE COMPANY INC | Agent | 251 LITTLE FALLS DRIVEWILMINGTON, DE 19808 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2015-05-14 | Name Change | Paragon Contracting Services, Inc. | Paragon Contracting Services, LLC |
Date of last update: 16 Aug 2024
Sources: Alabama Secretary of State
