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Anniston Medical Clinic P. C.

Details

Name: Anniston Medical Clinic P. C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 01 May 1976 (49 years ago) (Companies founded in May 1976)
Entity Number: 000-041-399
Register Number: 000041399
ZIP code: 36202 (Companies in Calhoun, 36202)
County: Calhoun
Place of Formation: Calhoun County
Principal Address: ANNISTON, AL
Registered Office Street Address: 1010 CHRISTINE AVEANNISTON, AL 36202
Authorized Capital: $25,000
Paid Share Capital: $1,050

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1619080017 2006-08-17 2016-03-08 PO BOX 2127, ANNISTON, AL, 362022127, US 1010 CHRISTINE AVE, ANNISTON, AL, 362075710, US

Contacts
Phone +1 256-236-5631
Fax 2562412241

Authorized person
Name VISHALA CHINDALORE
Role RHEUMATOLOGIST
Phone 2562365631

Taxonomy
Taxonomy Code 207Q00000X - Family Medicine Physician
State AL
Is Primary No
Taxonomy Code 207R00000X - Internal Medicine Physician
State AL
Is Primary Yes
Taxonomy Code 207RH0003X - Hematology & Oncology Physician
State AL
Is Primary No
Taxonomy Code 207RP1001X - Pulmonary Disease Physician
State AL
Is Primary No
Taxonomy Code 207RR0500X - Rheumatology Physician
State AL
Is Primary No
Taxonomy Code 261QM1300X - Multi-Specialty Clinic/Center
State AL
Is Primary No

Other Provider Identifiers
Issuer NHC HEALTH BENEFIT PLAN
Number 00013001
State AL
Issuer MEDICAID
Number 000060227
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ANNISTON MEDICAL CLINIC, 401(K) PROFIT SHARING PLAN 2023 630704915 2024-10-14 ANNISTON MEDICAL CLINIC P.C. 85
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1976-09-16
Business code 621111
Sponsor’s telephone number 2562365631
Plan sponsor’s address 1010 CHRISTINE AVENUE, ANNISTON, AL, 36207
ANNISTON MEDICAL CLINIC, 401(K) PROFIT SHARING PLAN 2022 630704915 2023-07-18 ANNISTON MEDICAL CLINIC P.C. 89
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1976-09-16
Business code 621111
Sponsor’s telephone number 2562365631
Plan sponsor’s address 1010 CHRISTINE AVENUE, ANNISTON, AL, 36207
ANNISTON MEDICAL CLINIC, 401(K) PROFIT SHARING PLAN 2021 630704915 2022-06-14 ANNISTON MEDICAL CLINIC P.C. 85
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1976-09-16
Business code 621111
Sponsor’s telephone number 2562365631
Plan sponsor’s address 1010 CHRISTINE AVENUE, ANNISTON, AL, 36207

Signature of
Role Plan administrator
Date 2022-06-14
Name of individual signing JENNIFER FAULKNER
ANNISTON MEDICAL CLINIC, 401(K) PROFIT SHARING PLAN 2020 630704915 2021-08-17 ANNISTON MEDICAL CLINIC P.C. 80
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1976-09-16
Business code 621111
Sponsor’s telephone number 2562365631
Plan sponsor’s address 1010 CHRISTINE AVENUE, ANNISTON, AL, 36207

Signature of
Role Plan administrator
Date 2021-08-17
Name of individual signing VISHALA CHINDALORE
ANNISTON MEDICAL CLINIC, 401(K) PROFIT SHARING PLAN 2019 630704915 2020-07-24 ANNISTON MEDICAL CLINIC P.C. 81
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1976-09-16
Business code 621111
Sponsor’s telephone number 2562365631
Plan sponsor’s address 1010 CHRISTINE AVENUE, ANNISTON, AL, 36207

Signature of
Role Plan administrator
Date 2020-07-24
Name of individual signing ANGELA EATON
ANNISTON MEDICAL CLINIC, 401(K) PROFIT SHARING PLAN 2018 630704915 2019-06-28 ANNISTON MEDICAL CLINIC P.C. 82
Three-digit plan number (PN) 002
Effective date of plan 1976-09-16
Business code 621111
Sponsor’s telephone number 2562365631
Plan sponsor’s address 1010 CHRISTINE AVENUE, ANNISTON, AL, 36207

Signature of
Role Plan administrator
Date 2019-06-28
Name of individual signing ASHLEY SMITH
ANNISTON MEDICAL CLINIC, 401(K) PROFIT SHARING PLAN 2018 630704915 2019-09-11 ANNISTON MEDICAL CLINIC P.C. 82
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1976-09-16
Business code 621111
Sponsor’s telephone number 2562365631
Plan sponsor’s address 1010 CHRISTINE AVENUE, ANNISTON, AL, 36207

Signature of
Role Plan administrator
Date 2019-09-11
Name of individual signing ASHLEY SMITH
ANNISTON MEDICAL CLINIC, 401(K) PROFIT SHARING PLAN 2017 630704915 2018-06-22 ANNISTON MEDICAL CLINIC P.C. 69
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1976-09-16
Business code 621111
Sponsor’s telephone number 2562365631
Plan sponsor’s address 1010 CHRISTINE AVENUE, ANNISTON, AL, 36207

Signature of
Role Plan administrator
Date 2018-06-22
Name of individual signing ASHLEY SMITH
ANNISTON MEDICAL CLINIC, 401(K) PROFIT SHARING PLAN 2016 630704915 2017-07-19 ANNISTON MEDICAL CLINIC P.C. 66
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1976-09-16
Business code 621111
Sponsor’s telephone number 2562365631
Plan sponsor’s address 1010 CHRISTINE AVENUE, ANNISTON, AL, 36207

Signature of
Role Plan administrator
Date 2017-07-19
Name of individual signing ASHLEY SMITH
ANNISTON MEDICAL CLINIC, 401(K) PROFIT SHARING PLAN 2015 630704915 2016-04-25 ANNISTON MEDICAL CLINIC P.C. 69
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1976-09-16
Business code 621111
Sponsor’s telephone number 2562365631
Plan sponsor’s address 1010 CHRISTINE AVENUE, ANNISTON, AL, 36207

Signature of
Role Plan administrator
Date 2016-04-25
Name of individual signing KIMBERLY STALLINGS

Agent

Name Role
READY, JAMES M Agent

Incorporator

Name Role
SARRELL, WARREN G Incorporator
LIKEY, ROBERT H Incorporator
EDWARDS, JOHN A JR Incorporator
STOUT, BILL D Incorporator
CHIN, CHANG KON Incorporator
REYNOLDS, WALKER JR Incorporator

Events

Event Date Event Type Old Value New Value
2000-10-20 Name Merged No data Anniston Clinic Facility, Inc.

Related by officers

SARRELL, WARREN G

Progressive Anniston, Inc.

STOUT, BILL D

Bill D. Stout, M.D.P.C.

REYNOLDS, WALKER JR

Reynolds-Horn Research Foundation, Inc. Anniston Country Club

Related by address

ANNISTON, AL

Abel Land & Development Company, Inc. Acme Sales Company of Anniston, Inc. Air Control Corporation Alabama Coca-Cola Bottling Company Alabama Parts Warehouse, Inc. Alabama Roofing and Sheet Metal Company, Inc. Alabama Throwing Company, Inc. John T. Davis Oil Company, Inc. Anniston Business Machines, Inc. Anniston Concrete Company, Inc.

Date of last update: 30 Jul 2024

Sources: Alabama Secretary of State

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