| Name: | Central Alabama Kidney & Hypertension Center, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 28 Apr 1995 (30 years ago) |
| Entity Number: | 000-171-781 |
| Register Number: | 000171781 |
| ZIP code: | 36104 |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Principal Address: | MONTGOMERY, AL |
| Registered Office Street Address: | 303 SOUTH RIPLEY STE 4300MONTGOMERY, AL 36104 |
| Authorized Capital: | $10,000 |
| Paid Share Capital: | ---- |
Activities
MEDICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922198373 | 2006-10-14 | 2010-06-21 | 4163 LOMAC ST, MONTGOMERY, AL, 361062881, US | 4163 LOMAC ST, MONTGOMERY, AL, 361062881, US | |||||||||||||||||||||||||||||||||||
|
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| Phone | +1 334-396-5570 |
| Fax | 3343965572 |
Authorized person
| Name | SHIRLEY KROTHAPALLI |
| Role | OFFICE MANAGER |
| Phone | 3343965570 |
Taxonomy
| Taxonomy Code | 207RN0300X - Nephrology Physician |
| License Number | 10666 AND 17288 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529501990 |
| State | AL |
| Issuer | DR. KROTHAPALLI'S NPI |
| Number | 1962592303 |
| State | AL |
| Issuer | DR. VARGHESE NPI |
| Number | 1841380284 |
| Name | Role |
|---|---|
| KROTHAPALLI, RADHA K | Agent |
| Name | Role |
|---|---|
| KROTHAPALLI, RADHA K | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
