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Tuscaloosa Lung & Sleep Consultants, P.C.

Details

Name: Tuscaloosa Lung & Sleep Consultants, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 17 Oct 1979 (45 years ago)
Entity Number: 000-058-655
Register Number: 000058655
Historical Names: Pulmonary & Intensive Care Medicine, P.C.
Snow Clinic, P.C.
Tuscaloosa Clinic, P.C.
County: Tuscaloosa
Place of Formation: Tuscaloosa County
Principal Address: TUSCALOOSA, AL
Registered Office Street Address: 701 UNIVERSITY BLVD E STE 711TUSCALOOSA, AL 35401
Registered Office Street Address ZIP Code: 35401
Authorized Capital: $1,000
Paid Share Capital: $150

Activities MEDICAL

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
CQULRSS2JZL3 2021-11-17 701 UNIVERSITY BLVD E STE 711, TUSCALOOSA, AL, 35401, 7433, USA 701 UNIVERSITY BLVD E, SUITE 711, TUSCALOOSA, AL, 35401, 7433, USA

Business Information
Congressional District 07
State/Country of Incorporation AL, USA
Activation Date 2020-11-24
Initial Registration Date 2020-11-17
Entity Start Date 1979-10-17
Fiscal Year End Close Date Dec 31

Service Classifications
NAICS Codes 621111

Points of Contacts
Electronic Business
Title PRIMARY POC
Name JASON STEVENS
Address 701 UNIVERSITY BLVD E, SUITE 711, TUSCALOOSA, AL, 35401, 7433, USA
Government Business
Title PRIMARY POC
Name JASON STEVENS
Address 701 UNIVERSITY BLVD E, SUITE 711, TUSCALOOSA, AL, 35401, 7433, USA
Past Performance Information not Available

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1447215561 2006-04-20 2013-09-16 701 UNIVERSITY BLVD E, SUITE 711, TUSCALOOSA, AL, 354012086, US 701 UNIVERSITY BLVD E, SUITE 711, TUSCALOOSA, AL, 354012086, US

Contacts
Phone +1 205-345-2255
Fax 2053450813

Authorized person
Name JASON STEVENS
Role MANAGER
Phone 2053452255

Taxonomy
Taxonomy Code 261QM2500X - Medical Specialty Clinic/Center
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 528401710
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TUSCALOOSA LUNG AND SLEEP CONSULTANTS 401(K) PLAN 2012 630778894 2013-05-01 TUSCALOOSA LUNG & SLEEP CONSULTANTS 27
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-03-01
Business code 621111
Sponsor’s telephone number 2053452255
Plan sponsor’s mailing address 701 UNIVERSTIY BLVD. E STE 711, TUSCALOOSA, AL, 35401
Plan sponsor’s address 701 UNIVERSTIY BLVD. E STE 711, TUSCALOOSA, AL, 35401

Plan administrator’s name and address
Administrator’s EIN 630778894
Plan administrator’s name TUSCALOOSA LUNG & SLEEP CONSULTANTS
Plan administrator’s address 701 UNIVERSTIY BLVD. E STE 711, TUSCALOOSA, AL, 35401
Administrator’s telephone number 2053452255

Number of participants as of the end of the plan year
Active participants 17
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 11
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 28
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2013-05-01
Name of individual signing PEDRO LOPEZ
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-05-01
Name of individual signing PEDRO LOPEZ
Valid signature Filed with authorized/valid electronic signature
TUSCALOOSA LUNG AND SLEEP CONSULTANTS 401(K) PLAN 2011 630778894 2012-05-15 TUSCALOOSA LUNG & SLEEP CONSULTANTS 27
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-03-01
Business code 621111
Sponsor’s telephone number 2053452255
Plan sponsor’s DBA name TUSCALOOSA LUNG, CRITICAL CARE & SLEEP
Plan sponsor’s mailing address 701 UNIVERSITY BLVD E, SUITE 711, TUSCALOOSA, AL, 35401
Plan sponsor’s address 701 UNIVERSITY BLVD E, SUITE 711, TUSCALOOSA, AL, 35401

Plan administrator’s name and address
Administrator’s EIN 630778894
Plan administrator’s name TUSCALOOSA LUNG & SLEEP CONSULTANTS
Plan administrator’s address 701 UNIVERSITY BLVD E, SUITE 711, TUSCALOOSA, AL, 35401
Administrator’s telephone number 2053452255

Number of participants as of the end of the plan year
Active participants 19
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 8
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 26
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2012-05-15
Name of individual signing PEDRO LOPEZ
Valid signature Filed with authorized/valid electronic signature
TUSCALOOSA LUNG AND SLEEP CONSULTANTS 401(K) PLAN 2010 630778894 2011-06-23 TUSCALOOSA LUNG & SLEEP CONSULTANTS 23
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-03-01
Business code 621111
Sponsor’s telephone number 2053452255
Plan sponsor’s mailing address 701 UNIVERSTIY BLVD. E STE 711, TUSCALOOSA, AL, 35401
Plan sponsor’s address 701 UNIVERSTIY BLVD. E STE 711, TUSCALOOSA, AL, 35401

Plan administrator’s name and address
Administrator’s EIN 630778894
Plan administrator’s name TUSCALOOSA LUNG & SLEEP CONSULTANTS
Plan administrator’s address 701 UNIVERSTIY BLVD. E STE 711, TUSCALOOSA, AL, 35401
Administrator’s telephone number 2053452255

Number of participants as of the end of the plan year
Active participants 20
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 7
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 25
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2011-06-23
Name of individual signing KYATHANAHALLY DINESH CHANDRA
Valid signature Filed with authorized/valid electronic signature
TUSCALOOSA LUNG AND SLEEP CONSULTANTS 401(K) PLAN 2009 630778894 2010-06-16 TUSCALOOSA LUNG & SLEEP CONSULTANTS 25
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1979-03-01
Business code 621111
Sponsor’s telephone number 2053452255
Plan sponsor’s mailing address 701 UNIVERSTIY BLVD. E STE 711, TUSCALOOSA, AL, 35401
Plan sponsor’s address 701 UNIVERSTIY BLVD. E STE 711, TUSCALOOSA, AL, 35401

Plan administrator’s name and address
Administrator’s EIN 630778894
Plan administrator’s name TUSCALOOSA LUNG & SLEEP CONSULTANTS
Plan administrator’s address 701 UNIVERSTIY BLVD. E STE 711, TUSCALOOSA, AL, 35401
Administrator’s telephone number 2053452255

Number of participants as of the end of the plan year
Active participants 18
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 5
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 23
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 1

Signature of
Role Plan administrator
Date 2010-06-16
Name of individual signing JEANNE LIPSCOMB
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
LOPEZ, PEDRO Agent

Incorporator

Name Role
SNOW, RICHARD M Incorporator

Events

Event Date Event Type Old Value New Value
2004-06-22 Name Change Tuscaloosa Clinic, P.C. Tuscaloosa Lung & Sleep Consultants, P.C.
1994-11-08 Capital Change $1,000 Authorized $1,000 Paid In $1,000 Authorized $150 Paid In
1992-04-06 Name Change Snow Clinic, P.C. Tuscaloosa Clinic, P.C.
1988-09-16 Name Change Pulmonary & Intensive Care Medicine, P.C. Snow Clinic, P.C.

Related by officers

LOPEZ, PEDRO

P and 3 C's, LLC

SNOW, RICHARD M

Technology Transfer Society, Huntsville Chapter The Richard M. Snow Foundation, Inc. Snow Sleep Center, P.C.

Related by address

TUSCALOOSA, AL

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Date of last update: 31 Jul 2024

Sources: Alabama Secretary of State

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