| Name: | Tuscaloosa Focus MD, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 02 Jul 2013 (12 years ago) |
| Entity Number: | 000-279-272 |
| Register Number: | 000279272 |
| ZIP code: | 35405 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Principal Address: | 1146 WISTERIA DRIVETUSCALOOSA, AL 35405 |
| Registered Office Street Address: | 11937 GRANDVIEW DRNORTHPORT, AL 35475 |
Activities
MEDICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1922440551 | 2013-07-24 | 2013-10-11 | PO BOX 8159, MOBILE, AL, 366890159, US | 720 ENERGY CENTER BLVD, STE 504, NORTHPORT, AL, 254732794, US | |||||||||||||||||||||||||
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| Phone | +1 251-414-5810 |
| Fax | 2514145809 |
| Phone | +1 205-301-2837 |
| Fax | 2055435530 |
Authorized person
| Name | MARK THOMAS |
| Role | OWNER |
| Phone | 2053012837 |
Taxonomy
| Taxonomy Code | 2080A0000X - Pediatric Adolescent Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 152344 |
| State | AL |
| Name | Role |
|---|---|
| THOMAS, RALPH | Agent |
| Name | Role | Address |
|---|---|---|
| THOMAS, MARK | Organizer | 361 COLLEGE STREETCOURTLAND, AL 35618 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 4344167303 | 2020-04-29 | 0459 | PPP | 720 ENERGY CENTER BLVD Ste 504, NORTHPORT, AL, 35473-2794 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
