| Name: | Central Pediatrics, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 22 May 2003 (22 years ago) |
| Entity Number: | 000-229-220 |
| Register Number: | 000229220 |
| ZIP code: | 35611 |
| County: | Limestone |
| Place of Formation: | Limestone County |
| Principal Address: | ATHENS, AL |
| Registered Office Street Address: | 213 S HOUSTON STATHENS, AL 35611 |
| Authorized Capital: | $5,000 |
| Paid Share Capital: | $1,000 |
Activities
OPERATE A PHYSICIAN/PEDIATRIC CLINIC
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467639534 | 2008-01-30 | 2008-01-30 | 707 US HIGHWAY 31 S, ATHENS, AL, 356113619, US | 707 US HIGHWAY 31 S, ATHENS, AL, 356113619, US | |||||||||||||||||||||||||
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| Phone | +1 256-233-0712 |
| Fax | 2562333535 |
Authorized person
| Name | MR. WESLEY C CROWELL |
| Role | OWNER/PRESIDENT |
| Phone | 2562330712 |
Taxonomy
| Taxonomy Code | 305R00000X - Preferred Provider Organization |
| License Number | 25244 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD AL |
| Number | 51517667 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| CROWELL, WESLEY | Agent | 707 US HIGHWAY 31 STE DATHENS, AL 35611 |
| Name | Role | Address |
|---|---|---|
| CROWELL, WESLEY | Incorporator | 707 US HIGHWAY 31 STE DATHENS, AL 35611 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
