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MOBILE PEDIATRIC CLINIC, LLC

Details

Name: MOBILE PEDIATRIC CLINIC, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 24 Jan 2012 (13 years ago)
Entity Number: 000-038-125
Register Number: 000038125
County: Mobile
Place of Formation: Mobile County
Registered Office Street Address: 1835 OLD SHELL ROADMOBILE, AL 36607
Registered Office Street Address ZIP Code: 36607

Activities TO INVEST IN/MANAGE/OPERATE REAL PROPERTY AND ITS IMPROVEMENTS

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1902352180 2016-08-29 2016-08-29 PO BOX 91899, MOBILE, AL, 366911899, US 6321 PICCADILLY SQUARE DR STE A, MOBILE, AL, 366095305, US

Contacts
Phone +1 251-342-8900
Fax 2513422333

Authorized person
Name AMY COLLINS
Role OWNER
Phone 2516101810

Taxonomy
Taxonomy Code 174400000X - Specialist
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MOBILE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2023 454575453 2024-08-26 MOBILE PEDIATRIC CLINIC, LLC 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2517068170
Plan sponsor’s address PO BOX 91899, MOBILE, AL, 36691

Signature of
Role Plan administrator
Date 2024-08-26
Name of individual signing JASON JOHNSON
MOBILE MEDICAL GROUP 401(K) PROFIT SHARING PLAN 2023 454575453 2024-08-26 MOBILE PEDIATRIC CLINIC, LLC 32
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2517068170
Plan sponsor’s address PO BOX 91899, MOBILE, AL, 36691

Signature of
Role Plan administrator
Date 2024-08-26
Name of individual signing JASON JOHNSON
MOBILE PEDIATRIC CLINIC SAFE HARBOR 401(K) PLAN 2022 454575453 2023-10-15 MOBILE PEDIATRIC CLINIC, LLC 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2517068170
Plan sponsor’s address PO BOX 91899, MOBILE, AL, 36691

Signature of
Role Plan administrator
Date 2023-10-15
Name of individual signing AMY COLLINS
MOBILE PEDIATRIC CLINIC SAFE HARBOR 401(K) PLAN 2021 454575453 2022-06-02 MOBILE PEDIATRIC CLINIC, LLC 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2517068170
Plan sponsor’s address PO BOX 91899, MOBILE, AL, 36691

Signature of
Role Plan administrator
Date 2022-06-02
Name of individual signing AMY COLLINS
MOBILE PEDIATRIC CLINIC SAFE HARBOR 401(K) PLAN 2020 454575453 2021-07-08 MOBILE PEDIATRIC CLINIC, LLC 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2517068170
Plan sponsor’s address 1835 OLD SHELL ROAD, MOBILE, AL, 36607

Signature of
Role Plan administrator
Date 2021-07-08
Name of individual signing AMY COLLINS
Role Employer/plan sponsor
Date 2021-07-08
Name of individual signing AMY COLLINS
MOBILE PEDIATRIC CLINIC SAFE HARBOR 401(K) PLAN 2019 454575453 2020-09-02 MOBILE PEDIATRIC CLINIC, LLC 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2517068170
Plan sponsor’s address 32 TACON STREET, SUITE A, MOBILE, AL, 36606

Signature of
Role Plan administrator
Date 2020-09-02
Name of individual signing AMY COLLINS
Role Employer/plan sponsor
Date 2020-09-02
Name of individual signing AMY COLLINS
MOBILE PEDIATRIC CLINIC SAFE HARBOR 401(K) PLAN 2018 454575453 2019-10-10 MOBILE PEDIATRIC CLINIC, LLC 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2517068170
Plan sponsor’s address 32 TACON STREET, SUITE A, MOBILE, AL, 36606

Signature of
Role Plan administrator
Date 2019-10-10
Name of individual signing AMY COLLINS
Role Employer/plan sponsor
Date 2019-10-10
Name of individual signing AMY COLLINS
MOBILE PEDIATRIC CLINIC SAFE HARBOR 401(K) PLAN 2017 454575453 2018-07-16 MOBILE PEDIATRIC CLINIC, LLC 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2517068170
Plan sponsor’s address 32 TACON STREET, SUITE A, MOBILE, AL, 36606

Signature of
Role Plan administrator
Date 2018-07-14
Name of individual signing AMY COLLINS
Role Employer/plan sponsor
Date 2018-07-14
Name of individual signing AMY COLLINS
MOBILE PEDIATRIC CLINIC SAFE HARBOR 401(K) PLAN 2016 454575453 2017-07-25 MOBILE PEDIATRIC CLINIC, LLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2517068170
Plan sponsor’s address 32 TACON STREET, SUITE A, MOBILE, AL, 36606

Signature of
Role Plan administrator
Date 2017-07-25
Name of individual signing AMY COLLINS
Role Employer/plan sponsor
Date 2017-07-25
Name of individual signing AMY COLLINS
MOBILE PEDIATRIC CLINIC SAFE HARBOR 401(K) PLAN 2015 454575453 2016-10-13 MOBILE PEDIATRIC CLINIC, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2517068170
Plan sponsor’s address 32 TACON STREET, SUITE A, MOBILE, AL, 36606

Signature of
Role Plan administrator
Date 2016-10-13
Name of individual signing AMY COLLINS

Agent

Name Role Address
COLLINS, AMY W Agent 254 WOODLANDS AVENUEMOBILE, AL 36607

Organizer

Name Role Address
COLLINS, AMY W Organizer 254 WOODLANDS AVENUEMOBILE, AL 36607
PEARSON, STEVEN C Organizer P O BOX 290MOBILE, AL 36601

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COLLINS, AMY W

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PEARSON, STEVEN C

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Related by address

No related companies by address

Date of last update: 30 Jul 2024

Sources: Alabama Secretary of State

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