| Name: | SouthCARE Clinic, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 26 Sep 2000 (24 years ago) |
| Date of dissolution: | 16 Nov 2022 |
| Entity Number: | 000-212-352 |
| Register Number: | 000212352 |
| ZIP code: | 35803 |
| County: | Madison |
| Place of Formation: | Madison County |
| Principal Address: | HUNTSVILLE, AL |
| Registered Office Street Address: | 11220 SOUTH MEMORIAL PARKWAYHUNTSVILLE, AL 35803 |
| Authorized Capital: | $100 |
| Paid Share Capital: | $100 |
Activities
EST A MEDICAL PRACTICE PROVIDING MEDICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1316034911 | 2006-10-06 | 2009-01-27 | 11220 MEMORIAL PKWY SW, SUITE AB, HUNTSVILLE, AL, 358034415, US | 11220 MEMORIAL PKWY SW, SUITE AB, HUNTSVILLE, AL, 358034415, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 256-880-5818 |
| Fax | 2568835346 |
Authorized person
| Name | DR. SAMUEL J. RIBIS |
| Role | OWNER |
| Phone | 2568805818 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 18641 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 98764 |
| State | AL |
| Issuer | NAMCI |
| Number | 98764 |
| State | AL |
| Name | Role |
|---|---|
| WITT, EDWARD | Agent |
| Name | Role |
|---|---|
| RIBIS, SAMUEL J | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
