| Name: | Clinic for Women, P.A. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Association |
| Status: | Exists |
| Date of registration: | 15 Jan 1969 (56 years ago) (Companies founded in January 1969) |
| Entity Number: | 000-004-405 |
| Register Number: | 000004405 |
| ZIP code: | 35801 (Companies in Madison, 35801) |
| County: | Madison |
| Place of Formation: | Madison County |
| Principal Address: | 303 WILLIAMS AVENUE STE 711HUNTSVILLE, AL 35801 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831346121 | 2008-08-19 | 2012-06-19 | 910 ADAMS ST SE, SUITE 300, HUNTSVILLE, AL, 358013730, US | 8337 HIGHWAY 72 W, SUITE 201, MADISON, AL, 357589573, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 256-533-7420 |
| Fax | 2565364109 |
| Fax | 2564640789 |
Authorized person
| Name | MS. AUDREY WEST |
| Role | PRACTICE ADMINISTRATOR |
| Phone | 2565337420 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE |
| Number | 12230 |
| State | AL |
| Issuer | MEDICARE |
| Number | 22684 |
| State | AL |
| Issuer | MEDICARE |
| Number | 22683 |
| State | AL |
| Issuer | MEDICARE |
| Number | 78546 |
| State | AL |
| Issuer | MEDICARE |
| Number | 26774 |
| State | AL |
| Issuer | MEDICARE |
| Number | 22645 |
| State | AL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CLINIC FOR WOMEN, P.A. 401(K) RETIREMENT PLAN | 2010 | 630571984 | 2011-10-14 | CLINIC FOR WOMEN, P.A. | 56 | |||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||
| Administrator’s EIN | 630571984 |
| Plan administrator’s name | CLINIC FOR WOMEN, P.A. |
| Plan administrator’s address | 910 ADAMS STREET, SUITE 300, HUNTSVILLE, AL, 35801 |
| Administrator’s telephone number | 2565337420 |
Signature of
| Role | Plan administrator |
| Date | 2011-10-14 |
| Name of individual signing | KIMBERLY H. HUBBARD, CPA |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 1971-08-09 |
| Business code | 621111 |
| Sponsor’s telephone number | 2565337420 |
| Plan sponsor’s address | 910 ADAMS STREET, SUITE 300, HUNTSVILLE, AL, 35801 |
Plan administrator’s name and address
| Administrator’s EIN | 630571984 |
| Plan administrator’s name | CLINIC FOR WOMEN, P.A. |
| Plan administrator’s address | 910 ADAMS STREET, SUITE 300, HUNTSVILLE, AL, 35801 |
| Administrator’s telephone number | 2565337420 |
Signature of
| Role | Plan administrator |
| Date | 2010-10-06 |
| Name of individual signing | KIMBERLY H. HUBBARD, CPA |
| Name | Role | Address |
|---|---|---|
| CAMERON, WILLIAM B | Member | No data |
| WELLS, JAMES C | Member | 608 CHACE LAKE PARKWAYBIRMINGHAM, AL 35244 |
| WARREN, CHARLES F | Member | 431 ECHOLS AVENUEHUNTSVILLE, AL 35801 |
Date of last update: 29 Jul 2024
Sources: Alabama Secretary of State
