| Name: | River Region Pain Management, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 18 Jun 2013 (12 years ago) |
| Entity Number: | 000-277-448 |
| Register Number: | 000277448 |
| ZIP code: | 36117 |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Registered Office Street Address: | 9411 DUNLEITHMONTGOMERY, AL 36117 |
| Authorized Capital: | 1,000 @ $1.00PV |
Activities
PAIN MANAGEMENT
ANESTHESIOLOGY
NURSE ANETHISIA
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1134568231 | 2013-06-21 | 2016-06-29 | PO BOX 660257, BIRMINGHAM, AL, 352660257, US | 3283 MALCOLM DR, SUITE 105, MONTGOMERY, AL, 361168816, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 205-979-5882 |
| Fax | 2059791248 |
| Phone | +1 334-356-9970 |
| Fax | 3343569873 |
Authorized person
| Name | BRAD A HOOKS |
| Role | PRESIDENT |
| Phone | 3344143435 |
Taxonomy
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | Yes |
| Taxonomy Code | 207LP2900X - Pain Medicine (Anesthesiology) Physician |
| Is Primary | No |
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 150179 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| VARNER, JONATHAN M | Director | 7057 OLD SOUTHWICK PLACEMONTGOMERY, AL 36117 |
| HOOKS, BRAD A | Director | 9411 DUNLEITHMONTGOMERY, AL 36117 |
| Name | Role | Address |
|---|---|---|
| MCBRIDE, RICHARD L JR | Incorporator | 1784 TALIAFERRO TRAIL STE BMONTGOMERY, AL 36117 |
| Name | Role | Address |
|---|---|---|
| HOOKS, BRAD A | Agent | 9411 DUNLEITHMONTGOMERY, AL 36117 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
