Pathology Associates, P.C.

Contacts

Fax	2564944234
Phone	+1 256-494-4026

Authorized person

Name	DR. RICHARD JAY WELLS
Role	ADMINISTRATIVE PARTNER
Phone	2564944026

Taxonomy

Taxonomy Code	207ZP0102X - Anatomic Pathology & Clinical Pathology Physician
Is Primary	Yes

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2018-08-01
Business code	621111
Sponsor’s telephone number	2565331480
Plan sponsor’s address	2904 WESTCORP BLVD SW, STE 108, HUNTSVILLE, AL, 358056436

Three-digit plan number (PN)	002
Effective date of plan	2018-08-01
Business code	621111
Sponsor’s telephone number	2565331480
Plan sponsor’s address	2904 WESTCORP BLVD SW, STE 108, HUNTSVILLE, AL, 358056436

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2018-08-01
Business code	621111
Sponsor’s telephone number	2565331480
Plan sponsor’s address	2904 WESTCORP BLVD SW, STE 108, HUNTSVILLE, AL, 358056436

Three-digit plan number (PN)	002
Effective date of plan	2018-08-01
Business code	621111
Sponsor’s telephone number	2565331480
Plan sponsor’s address	2904 WESTCORP BLVD SW, STE 108, HUNTSVILLE, AL, 358056436

Signature of

Role	Plan administrator
Date	2022-02-18
Name of individual signing	L. ALLEN PERKINS
Role	Employer/plan sponsor
Date	2022-02-18
Name of individual signing	L. ALLEN PERKINS

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2018-08-01
Business code	621111
Sponsor’s telephone number	2565331480
Plan sponsor’s address	2904 WESTCORP BLVD SW, STE 108, HUNTSVILLE, AL, 358056436

Signature of

Role	Plan administrator
Date	2022-06-28
Name of individual signing	L. ALLEN PERKINS

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2018-08-01
Business code	621111
Sponsor’s telephone number	2565331480
Plan sponsor’s address	2904 WESTCORP BLVD SW, STE 108, HUNTSVILLE, AL, 358056436

Signature of

Role	Plan administrator
Date	2021-02-09
Name of individual signing	L. ALLEN PERKINS

File	View Page
Three-digit plan number (PN)	002
Effective date of plan	2018-08-01
Business code	621111
Sponsor’s telephone number	2565331480
Plan sponsor’s address	2904 WESTCORP BLVD SW, STE 108, HUNTSVILLE, AL, 358056436

File	View Page
Three-digit plan number (PN)	003
Effective date of plan	1993-01-01
Business code	621111
Sponsor’s telephone number	2055470486
Plan sponsor’s address	P O BOX 1798, 1050 FORREST AVE, GADSDEN, AL, 359021798

Plan administrator’s name and address

Administrator’s EIN	630435624
Plan administrator’s name	PATHOLOGY ASSOCIATES
Plan administrator’s address	P O BOX 1798, 1050 FORREST AVE, GADSDEN, AL, 359021798
Administrator’s telephone number	2055470486

Signature of

Role	Plan administrator
Date	2010-09-16
Name of individual signing	H. EARLE GARVIN

Unique Award Key	CONT_AWD_W91YTV05P0010_9700_-NONE-_-NONE-
Awarding Agency	Department of Defense
Link	View Page

Description

Title	ANATOMIC PATHOLOGY SERVICE
NAICS Code	621511: MEDICAL LABORATORIES
Product and Service Codes	Q515: MEDICAL- PATHOLOGY

Recipient Details

Recipient	PATHOLOGY ASSOCIATES PC
UEI	CLLEDZDJE7M3
Legacy DUNS	360703961
Recipient Address	UNITED STATES, 803 FRANKLIN STREET, HUNTSVILLE, 35801