| Name: | Urology Centers of Alabama, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 26 Sep 1977 (47 years ago) |
| Entity Number: | 000-047-981 |
| Register Number: | 000047981 |
| Historical Names: |
Urology Associates, P.C.
Urology Centers of Alabama, P.C. Urology Centers of the South, P.C. |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 3485 INDEPENDENCE DRIVEBIRMINGHAM, AL 35209 |
| Registered Office Street Address ZIP Code: | 35209 |
| Authorized Capital: | $1,050 |
| Paid Share Capital: | $1,000 |
Activities
MEDICAL PRACTICE/SURGERY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023861796 | 2024-04-10 | 2024-08-19 | 3485 INDEPENDENCE DR, BIRMINGHAM, AL, 352095603, US | 3485 INDEPENDENCE DR STE 200, BIRMINGHAM, AL, 352095603, US | |||||||||||||||||||||||||
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| Phone | +1 205-445-0183 |
| Fax | 2052635153 |
Authorized person
| Name | DR. LOGAN TYLER STYKE |
| Role | SUPERVISOR OF PHARMACY SERVICES |
| Phone | 2054144557 |
Taxonomy
| Taxonomy Code | 3336C0002X - Clinic Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | ALABAMA BOARD OF PHARMACY |
| Number | 115281 |
| State | AL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| UROLOGY CENTERS OF ALABAMA, P.C. CASH BALANCE PENSION PLAN | 2011 | 630581180 | 2012-07-18 | UROLOGY CENTERS OF ALABAMA, P. C. | 107 | |||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 630581180 |
| Plan administrator’s name | UROLOGY CENTERS OF ALABAMA, P. C. |
| Plan administrator’s address | 3485 INDEPENDENCE DRIVE, HOMEWOOD, AL, 352095603 |
| Administrator’s telephone number | 2059300920 |
Signature of
| Role | Plan administrator |
| Date | 2012-07-18 |
| Name of individual signing | MARK S. DEGUENTHER, M. D. |
| Role | Employer/plan sponsor |
| Date | 2012-07-18 |
| Name of individual signing | MARK S. DEGUENTHER, M. D. |
| File | View Page |
| Three-digit plan number (PN) | 004 |
| Effective date of plan | 2008-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2059300920 |
| Plan sponsor’s address | 3485 INDEPENDENCE DRIVE, HOMEWOOD, AL, 352095603 |
Plan administrator’s name and address
| Administrator’s EIN | 630581180 |
| Plan administrator’s name | UROLOGY CENTERS OF ALABAMA, P. C. |
| Plan administrator’s address | 3485 INDEPENDENCE DRIVE, HOMEWOOD, AL, 352095603 |
| Administrator’s telephone number | 2059300920 |
Signature of
| Role | Plan administrator |
| Date | 2011-08-18 |
| Name of individual signing | MARK S. DEGUENTHER, M. D. |
| Role | Employer/plan sponsor |
| Date | 2011-08-18 |
| Name of individual signing | MARK S. DEGUENTHER, M. D. |
| File | View Page |
| Three-digit plan number (PN) | 004 |
| Effective date of plan | 2008-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2059300920 |
| Plan sponsor’s address | 3485 INDEPENDENCE DRIVE, HOMEWOOD, AL, 352095603 |
Plan administrator’s name and address
| Administrator’s EIN | 630581180 |
| Plan administrator’s name | UROLOGY CENTERS OF ALABAMA, P. C. |
| Plan administrator’s address | 3485 INDEPENDENCE DRIVE, HOMEWOOD, AL, 352095603 |
| Administrator’s telephone number | 2059300920 |
Signature of
| Role | Plan administrator |
| Date | 2010-09-28 |
| Name of individual signing | MARK S. DEGUENTHER, M. D. |
| Role | Employer/plan sponsor |
| Date | 2010-09-28 |
| Name of individual signing | MARK S. DEGUENTHER, M. D. |
| Name | Role |
|---|---|
| KC TEMPLIN | Agent |
| Name | Role | Address |
|---|---|---|
| SCOTT, EDWARD VAN ZILE | Incorporator | 1000 SOUTH 14TH STREETBIRMINGHAM, AL |
| DEASON, A M JR | Incorporator | No data |
| CROWE, A DERRILL | Incorporator | 1000 SOUTH 14TH STREETBIRMINGHAM, AL |
| TULLY, ALBERT J JR | Incorporator | No data |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2015-07-17 | Name Change | Urology Centers of the South, P.C. | Urology Centers of Alabama, P.C. |
| 2015-06-12 | Name Change | Urology Centers of Alabama, P.C. | Urology Centers of the South, P.C. |
| 2014-02-24 | Name Merged | No data | Poole Urology, P.C. |
| 2011-12-27 | Name Merged | No data | Eastern Urology Associates, P.A. |
| 2011-12-27 | Name Merged | No data | Birmingham-Shelby Urology, P.C. |
| 1998-06-08 | Name Change | Urology Associates, P.C. | Urology Centers of Alabama, P.C. |
| 1996-12-31 | Name Merged | No data | Urologists, P.C. |
| 1989-02-07 | Capital Change | $5,000 Authorized $1,000 Paid In | $1,050 Authorized $1,000 Paid In |
| 1980-09-12 | Name Merged | No data | Birmingham Urology Group, P. C. |
| 1979-10-01 | Name Merged | No data | William A. Leitner, M.D., P.A. |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
