| Name: | Palmer Psychiatric Services, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 24 Feb 1998 (27 years ago) |
| Entity Number: | 000-193-927 |
| Register Number: | 000193927 |
| ZIP code: | 36116 |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Principal Address: | MONTGOMERY, AL |
| Registered Office Street Address: | 2978 BALDWINBROOK DRIVEMONTGOMERY, AL 36116 |
| Authorized Capital: | 10 |
Activities
PSYCHIATRIC SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124288436 | 2008-06-10 | 2020-04-24 | 3090 WOODLEY RD, MONTGOMERY, AL, 361163100, US | 3090 WOODLEY RD, SUITE A, MONTGOMERY, AL, 361163100, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 334-280-3230 |
| Fax | 3342803272 |
Authorized person
| Name | DR. CLEMMIE L PALMER |
| Role | PSYCHIATRIST |
| Phone | 3342803230 |
Taxonomy
| Taxonomy Code | 2084P0800X - Psychiatry Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD FEDERAL PROGRAM |
| Number | 51099544 |
| State | AL |
| Issuer | VALUE OPTIONS |
| Number | 274116 |
| State | AL |
| Issuer | BLUE CROSS BLUE SHIELD OF ALABAMA |
| Number | 51077444 |
| State | AL |
| Issuer | MEDICAID |
| Number | 529803110 |
| State | AL |
| Issuer | RAILROAD MEDICARE |
| Number | 260043194 |
| State | AL |
| Issuer | AETNA |
| Number | 0005521738 |
| State | AL |
| Issuer | UNITED HEALTHCARE |
| Number | 1505325 |
| State | AL |
| Name | Role |
|---|---|
| PALMER, CLEMMIE III | Incorporator |
| Name | Role |
|---|---|
| PALMER, CLEMMIE III | Agent |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
