| Name: | Family Practice Center of Huntsville, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 08 Jun 1994 (31 years ago) |
| Entity Number: | 000-164-757 |
| Register Number: | 000164757 |
| ZIP code: | 35801 |
| County: | Madison |
| Place of Formation: | Madison County |
| Principal Address: | HUNTSVILLE, AL |
| Registered Office Street Address: | 401 LOWELL DRHUNTSVILLE, AL 35801 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
Activities
PRACTICE OF MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1700837010 | 2006-05-12 | 2015-07-21 | 401 LOWELL DR SE, SUITE 22, HUNTSVILLE, AL, 358013748, US | 401 LOWELL DR SE, SUITE 22, HUNTSVILLE, AL, 358013748, US | |||||||||||||||||||||||||||||||
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| Phone | +1 256-539-6900 |
| Fax | 2565396997 |
Authorized person
| Name | DR. CAROLYN TAYLOR-MORNS |
| Role | CEO |
| Phone | 2565396900 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| License Number | 14537 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE PTAN |
| Number | 000022751 |
| State | AL |
| Issuer | MEDICAID |
| Number | 529403070 |
| State | AL |
| Name | Role |
|---|---|
| TAYLOR-MORNS, CAROLYN MD | Agent |
| Name | Role |
|---|---|
| TAYLOR-MORNS, CAROLYN MD | Incorporator |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 3476287802 | 2020-05-26 | 0459 | PPP | 401 LOWELL DR SE SUITE 22, HUNTSVILLE, AL, 35801-3738 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
