| Name: | Alabama Care Plan |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Dissolved |
| Date of registration: | 18 Sep 2014 (10 years ago) |
| Date of dissolution: | 28 Sep 2020 |
| Entity Number: | 000-318-462 |
| Register Number: | 000318462 |
| ZIP code: | 35203 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 417 20TH STREET NORTH SUITE 1100BIRMINGHAM, AL 35203 |
Activities
REGIONAL CARE ORG TO COORDINATE THE HEALTH CARE OF MEDICAID PATI
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1396137402 | 2015-02-26 | 2015-02-26 | 417 20TH ST N, SUITE 1100, BIRMINGHAM, AL, 352033203, US | 417 20TH ST N, SUITE 1100, BIRMINGHAM, AL, 352033203, US | |||||||||||||||||||
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| Phone | +1 205-558-7641 |
| Fax | 2054497626 |
Authorized person
| Name | MR. BRAD ROLLOW |
| Role | SECRETARY-TREASURER |
| Phone | 2055587401 |
Taxonomy
| Taxonomy Code | 302F00000X - Exclusive Provider Organization |
| License Number | MEDICAID RCO |
| State | AL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| FERNIANY, WILLIAM | Director | 500 22ND STREET SOUTH, SUITE 408BIRMINGHAM, AL 35233 |
| ANDREWS, WILLIAM W | Director | 619 19TH STREET S 176F 10360BIRMINGHAM, AL 35249 |
| RUE, LORING W | Director | 1922 7TH AVE S KB120BIRMINGHAM, AL 35294 |
| LILLY, DON | Director | 500 22ND ST SBIRMINGHAM, AL 35233 |
| BULGARELLA, S DAWN | Director | 7413 ASHLAND LANEVESTAVIA HILLS, AL 35242 |
| CURRY, BILL | Director | FOT 720 1720 2ND AVE SBIRMINGHAM, AL 35294 |
| ROLLOW, BRAD | Director | 417 20TH STREET NORTH SUITE 1100BIRMINGHAM, AL 35203 |
| FEAGIN, CARDWELL | Director | 417 20TH STREET NORTH SUITE 1100BIRMINGHAM, AL 35203 |
| VELASCO, ANNA | Director | 417 20TH STREET NORTH SUITE 1100BIRMINGHAM, AL 35203 |
| JOHNSON, JUAN | Director | 832 PRINCETON AVE SWBIRMINGHAM, AL 35211 |
| Name | Role | Address |
|---|---|---|
| EARNHARDT, CAMERON T | Incorporator | 701 20TH STREET SUITE 820BIRMINGHAM, AL 35233 |
| Name | Role | Address |
|---|---|---|
| ROLLOW, BRAD | Agent | 417 20TH STREET NORTH SUITE 1100BIRMINGHAM, AL 35203 |
Date of last update: 03 Aug 2024
Sources: Alabama Secretary of State
