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Birmingham Surgical, P.C.

Details

Name: Birmingham Surgical, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 30 Sep 1975 (49 years ago) (Companies founded in September 1975)
Entity Number: 000-036-457
Register Number: 000036457
Historical Names: Birmingham Surgical, P.A.
ZIP code: 35209 (Companies in Jefferson, 35209)
County: Jefferson
Place of Formation: Chambers County
Principal Address: BIRMINGHAM, AL
Registered Office Street Address: 513 BROOKWOOD BOULEVARD, SUITE 360BIRMINGHAM, AL 35209
Authorized Capital: $5,000
Paid Share Capital: ----

Activities SURGICAL CENTER

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1922068774 2006-03-24 2018-06-21 2022 BROOKWOOD MEDICAL CTR DR, SUITE 313 ACC, BIRMINGHAM, AL, 352096808, US 2022 BROOKWOOD MEDICAL CTR DR, SUITE 313 ACC, BIRMINGHAM, AL, 352096808, US

Contacts
Phone +1 205-877-2910
Fax 2058794649

Authorized person
Name MR. BRIAN DEREK LASKER
Role ADMINISTRATOR
Phone 2058772910

Taxonomy
Taxonomy Code 208600000X - Surgery Physician
Is Primary Yes

Other Provider Identifiers
Issuer BROUP BILLING BLUE CROSS
Number C321
State AL
Issuer NPI
Number 1043279797
State AL
Issuer NPI
Number 1457311250
State AL
Issuer MEDICAID
Number 528500610
State AL
Issuer NPI
Number 1750341756
State AL
Issuer GROUP NPI
Number 1922068774
Issuer NPI
Number 1306805825
State AL
Issuer NPI
Number 1326008129
State AL
Issuer NPI
Number 1780644591
State AL
Issuer GROUP RAILROAD MEDICARE
Number CM7410

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BIRMINGHAM SURGICAL, P.C. 401K PROFIT SHARING PLAN 2022 630677675 2024-03-12 BIRMINGHAM SURGICAL, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-10-01
Business code 621111
Sponsor’s telephone number 2058772910
Plan sponsor’s address 513 BROOKWOOD BLVD, SUITE 360, BIRMINGHAM, AL, 352097826
BIRMINGHAM SURGICAL, P.C. 401K PROFIT SHARING PLAN 2021 630677675 2023-04-14 BIRMINGHAM SURGICAL, P.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-10-01
Business code 621111
Sponsor’s telephone number 2058772910
Plan sponsor’s address 513 BROOKWOOD BLVD, SUITE 360, BIRMINGHAM, AL, 352097826
BIRMINGHAM SURGICAL, P.C. 401K PROFIT SHARING PLAN 2020 630677675 2022-02-08 BIRMINGHAM SURGICAL, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-10-01
Business code 621111
Sponsor’s telephone number 2058772910
Plan sponsor’s address 513 BROOKWOOD BLVD, SUITE 360, BIRMINGHAM, AL, 352097826
BIRMINGHAM SURGICAL, P.C. 401K PROFIT SHARING PLAN 2019 630677675 2021-02-03 BIRMINGHAM SURGICAL, P.C. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-10-01
Business code 621111
Sponsor’s telephone number 2058772910
Plan sponsor’s address 513 BROOKWOOD BLVD, SUITE 360, BIRMINGHAM, AL, 352097826
BIRMINGHAM SURGICAL, P.C. 401K PROFIT SHARING PLAN 2018 630677675 2020-01-16 BIRMINGHAM SURGICAL, P.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-10-01
Business code 621111
Sponsor’s telephone number 2058772910
Plan sponsor’s address 513 BROOKWOOD BLVD, SUITE 360, BIRMINGHAM, AL, 352097826
BIRMINGHAM SURGICAL, P.C. 401K PROFIT SHARING PLAN 2017 630677675 2019-01-16 BIRMINGHAM SURGICAL, P.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-10-01
Business code 621111
Sponsor’s telephone number 2058772910
Plan sponsor’s address 2022 BROOKWOOD MEDICAL CTR DR #313, BIRMINGHAM, AL, 352096807
BIRMINGHAM SURGICAL, P.C. 401K PROFIT SHARING PLAN 2016 630677675 2018-01-26 BIRMINGHAM SURGICAL, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-10-01
Business code 621111
Sponsor’s telephone number 2058772910
Plan sponsor’s address 2022 BROOKWOOD MEDICAL CTR DR #313, BIRMINGHAM, AL, 352096807
BIRMINGHAM SURGICAL, P.C. 401K PROFIT SHARING PLAN 2015 630677675 2017-04-03 BIRMINGHAM SURGICAL, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-10-01
Business code 621111
Sponsor’s telephone number 2058772910
Plan sponsor’s address 2022 BROOKWOOD MEDICAL CTR DR #313, BIRMINGHAM, AL, 352096807

Signature of
Role Plan administrator
Date 2017-04-03
Name of individual signing MIMI SMITH, M.D.
BIRMINGHAM SURGICAL, P.C. 401K PROFIT SHARING PLAN 2014 630677675 2015-12-07 BIRMINGHAM SURGICAL, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-10-01
Business code 621111
Sponsor’s telephone number 2058772910
Plan sponsor’s address 2022 BROOKWOOD MEDICAL CTR DR #313, BIRMINGHAM, AL, 352096807

Signature of
Role Plan administrator
Date 2015-12-07
Name of individual signing MIMI SMITH, M.D.
BIRMINGHAM SURGICAL, P.C. 401K PROFIT SHARING PLAN 2013 630677675 2014-12-10 BIRMINGHAM SURGICAL, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1985-10-01
Business code 621111
Sponsor’s telephone number 2058772910
Plan sponsor’s address 2022 BROOKWOOD MEDICAL CTR DR #313, BIRMINGHAM, AL, 352096807

Signature of
Role Plan administrator
Date 2014-12-10
Name of individual signing MIMI SMITH, M.D.

Incorporator

Name Role
CAMPBELL, ERNEST S JR Incorporator

Agent

Name Role
BRENDON HAIKES, M.D. Agent

Events

Event Date Event Type Old Value New Value
1992-09-28 Name Change Birmingham Surgical, P.A. Birmingham Surgical, P.C.

Related by officers

CAMPBELL, ERNEST S JR

Old Orchard Road Pediatrics, P.C.

Related by address

BIRMINGHAM, AL

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Date of last update: 30 Jul 2024

Sources: Alabama Secretary of State

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