| Name: | Diabetes Care Center, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 29 Jul 1998 (26 years ago) |
| Entity Number: | 000-197-097 |
| Register Number: | 000197097 |
| ZIP code: | 35243 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Principal Address: | BIRMINGHAM, AL |
| Registered Office Street Address: | 4025 ROYAL OAK CTBIRMINGHAM, AL 35243 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
Activities
INDEPENDENT CONTRACTOR
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497746085 | 2005-11-02 | 2020-08-22 | 1792 AL HIGHWAY 157, CULLMAN, AL, 350583622, US | 1792 AL HIGHWAY 157, CULLMAN, AL, 350583622, US | |||||||||||||||||||||||||||
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| Phone | +1 256-737-2025 |
| Fax | 2567372829 |
Authorized person
| Name | MR. JETE EDMISSON |
| Role | VICE PRESIDENT OF FINANCE |
| Phone | 2567372595 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | H0S0035H |
| State | AL |
| Issuer | BLUE CROSS |
| Number | 010049 |
| State | AL |
| Name | Role |
|---|---|
| DYER, T RAY | Agent |
| Name | Role |
|---|---|
| DYER, T RAY | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
