| Name: | Four Seasons Medical Supply, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Foreign Corporation |
| Status: | Exists |
| Date of registration: | 08 Jun 2004 (20 years ago) |
| Entity Number: | 000-931-342 |
| Register Number: | 000931342 |
| County: | Jefferson |
| Place of Formation: | Delaware |
| Principal Address: | 4201 SUPER HWYBESSEMER, AL 35020 |
| Principal Address ZIP Code: | 35020 |
| Registered Office Street Address: | 4201 BESSEMER SUPER HWYBESSEMER, AL 35020 |
| Registered Office Street Address ZIP Code: | 35020 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1407967938 | 2006-08-31 | 2009-11-10 | 4201 BESSEMER SUPER HWY, BESSEMER, AL, 350202412, US | 4201 BESSEMER SUPER HWY, BESSEMER, AL, 350202412, US | |||||||||||||||||||||||||
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| Phone | +1 205-428-0147 |
| Fax | 2054257231 |
Authorized person
| Name | JEANNE TAYLOR |
| Role | BILLER |
| Phone | 2054280147 |
Taxonomy
| Taxonomy Code | 332BN1400X - Nursing Facility Supplies (DME) |
| License Number | 06015325 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009933183 |
| State | AL |
| Name | Role |
|---|---|
| BAIRD, LAURENCE A | Agent |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
