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 | |||||||||||||||||||||||||
|
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 | |||||||||||||||||||||||||||||||||||||
|
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