Alabama Healthcare Advantage East

Details

Name:	Alabama Healthcare Advantage East
Jurisdiction:	Alabama
Legal type:	Domestic Non-Profit Corporation
Status:	Dissolved
Date of registration:	16 Oct 2014 (10 years ago)
Date of dissolution:	28 Apr 2017
Entity Number:	000-320-771
Register Number:	000320771
ZIP code:	36117
County:	Montgomery
Place of Formation:	Montgomery County
Principal Address:	8650 MINNIE BROWN RD SUITE 224MONTGOMERY, AL 36117
Registered Office Street Address:	2740 ZELDA ROADMONTGOMERY, AL 36106

Activities TO BECOME A MEDICAID RCO IN REGION

NPI

Enumeration Date

Last Update Date

Mailing Address

Practice Location Address

1053776773

2015-12-22

8650 MINNIE BROWN RD STE 224, MONTGOMERY, AL, 361177433, US

Contacts

Phone

+1 334-215-3985

Authorized person

Taxonomy

Taxonomy Code	251K00000X - Public Health or Welfare Agency
Is Primary	Yes

Name	Role	Address
MOORE, BRIAN W	Agent	2740 ZELDA ROADMONTGOMERY, AL 36106

Name	Role	Address
CAMERIO, MICHAEL L	Director	8650 MINNIE BROWN RD SUITE 224MONTGOMERY, AL 36117
WHITNEY, TODD W	Director	8650 MINNIE BROWN RD SUITE 224MONTGOMERY, AL 36117
ENSLEY, RICHARD	Director	223 DRIFTWOOD LANETALLASSEE, AL 36078
REDDEN, JOHN	Director	231 WALBASH DRIVEMONTGOMERY, AL 36116
TAYLOR, DOUG	Director	7472 SOUTH TUSCON WAY SUITE 100CENTENNIAL, CO 80112
WARREN, EDDIE	Director	714 NORTH THREE NOTCH STREETTROY, AL 36081
FULGHAM, HENRY	Director	1515 UNIVERSITY BOULEVARD SOUTHMOBILE, AL 36609
BALL, KEVIN	Director	122 BAY POINTE LANEMADISON, AL 35758
BRUCE, MIKE	Director	201 MARIARDEN RDDADEVILLE, AL 36853
WARREN, JOHNNY	Director	1501 NOBLE STREETANNISTON, AL 36201
ROGERS, CLEON	Director	5720 1ST AVE SOUTHBIRMINGHAM, AL 35212
JUNKINS, JASON	Director	115 WEST GRAND AVENUERAINBOW CITY, AL 35906
TRAFFANSTEDT, DARLENE	Director	5330 STADIUM TRACE PARKWAY 150BIRMINGHAM, AL 35244
STEELE, ZACK	Director	133 CHALKVILLE ROADTRUSSVILLE, AL 35173
WOLSONCROFT, LEA	Director	1933 RIVER WAY DRIVEBIRMINGHAM, AL 35244
HELMS, MARK	Director	931 CHOSEA SPRINGS ROADANNISTON, AL 36207
PARKER, CAROLYN	Director	1601 ARROWHEAD DRIVE; GADSDEN, ALABAGADSDEN, AL 35901-2323
BROCK, JON	Director	816 CONROY ROADBIRMINGHAM, AL 35222
PATCHEN, JASON	Director	3505 E FRONTAGE ROAD, STE 250TAMPA, FL 33607
HUNTER, JESSE	Director	7700 FORSYTH BLVDST. LOUIS, MO 63105

Name	Role	Address
CAMERIO, MICHAEL L	Incorporator	8650 MINNIE BROWN RD SUITE 224MONTGOMERY, AL 36117
WHITNEY, TODD W	Incorporator	8650 MINNIE BROWN RD SUITE 224MONTGOMERY, AL 36117
ENSLEY, RICHARD	Incorporator	223 DRIFTWOOD LANETALLASSEE, AL 36078

Date of last update: 03 Aug 2024