| Name: | Vascular Center of Mobile, PC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 13 Jun 2011 (14 years ago) |
| Entity Number: | 000-015-939 |
| Register Number: | 000015939 |
| ZIP code: | 36607 |
| County: | Mobile |
| Place of Formation: | Mobile County |
| Registered Office Street Address: | 51 TACON STREET STE C2MOBILE, AL 36607 |
| Authorized Capital: | 10,000 @ $.10PV |
Activities
ANY LAWFUL BUSINESS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295013696 | 2011-08-02 | 2022-07-01 | 1151 DAUPHIN ST, MOBILE, AL, 366042547, US | 1151 DAUPHIN ST, MOBILE, AL, 36604, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 251-455-0075 |
| Fax | 2514450072 |
| Phone | +1 251-445-0075 |
Authorized person
| Name | ALYSSA N SEABROOK |
| Role | INSURANCE SPECIALIST |
| Phone | 2514450075 |
Taxonomy
| Taxonomy Code | 2086S0129X - Vascular Surgery Physician |
| License Number | MD19175 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 131068 |
| State | AL |
| Issuer | BLUE CROSS BLUE SHIELD OF ALABAMA |
| Number | 51118091 |
| State | AL |
| Issuer | GLENN E. ESSES, M.D. - INDIVIDUAL NPI |
| Number | 1912900283 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| CORRIGAN, RICHARD E | Agent | 51 NORTH TACON STREET, SUITE C2MOBILE, AL 36607 |
| Name | Role | Address |
|---|---|---|
| CORRIGAN, RICHARD E | Director | 51 NORTH TACON STREET, SUITE C2MOBILE, AL 36607 |
| Name | Role | Address |
|---|---|---|
| CORRIGAN, RICHARD E | Incorporator | 51 NORTH TACON STREET, SUITE C2MOBILE, AL 36607 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 7866747105 | 2020-04-14 | 0459 | PPP | 1151 Dauphin Street, MOBILE, AL, 36604-2547 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
