| Name: | Limestone Internal Medicine, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 04 Jun 1998 (27 years ago) |
| Entity Number: | 000-195-744 |
| Register Number: | 000195744 |
| ZIP code: | 35749 |
| County: | Madison |
| Place of Formation: | Limestone County |
| Principal Address: | HARVEST, AL |
| Registered Office Street Address: | 14424 E LIMESTONE RDHARVEST, AL 35749 |
| Authorized Capital: | $5,000 |
Activities
PRACTICE OF MEDICINE
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TA5KGUFL7WB7 | 2023-12-20 | 1005 W MARKET ST, STE 7, ATHENS, AL, 35611, 2454, USA | 1005 W MARKET ST STE 7, ATHENS, AL, 35611, 2454, USA | |||||||||||||||||||||||||||||||||||
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| Congressional District | 05 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2022-12-22 |
| Initial Registration Date | 2022-01-12 |
| Entity Start Date | 2004-05-01 |
| Fiscal Year End Close Date | Jun 30 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | CHARITY HOLLADAY |
| Address | 108 SANDERS SUIT SUITE A, ATHENS, AL, 35611, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | CHARITY HOLLADAY |
| Address | 108 SANDERS SUIT SUITE A, ATHENS, AL, 35611, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417264425 | 2010-09-13 | 2010-09-13 | 710 WEST HOBBS STREET, ATHENS, AL, 356111508, US | 710 W HOBBS ST, ATHENS, AL, 356111508, US | |||||||||||||||||||||||
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| Phone | +1 256-233-6311 |
Authorized person
| Name | DR. JAMES RUSSELL WALKER |
| Role | PRESIDENT |
| Phone | 2562336311 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| License Number | 13208 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 000077994 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| WALKER, JAMES R | Incorporator | 210 PLANTATION SPRINGSPLANTATION, AL 35630 |
| Name | Role | Address |
|---|---|---|
| WALKER, JAMES R | Agent | 210 PLANTATION SPRINGSPLANTATION, AL 35630 |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
