Menu
Search icon

Northport Internal Medicine, P.C.

Details

Name: Northport Internal Medicine, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 03 Apr 1980 (45 years ago)
Entity Number: 000-060-998
Register Number: 000060998
Historical Names: Hayse Boyd, M.D., P.A.
Drs. Boyd & Browne, P.C.
County: Tuscaloosa
Place of Formation: Tuscaloosa County
Principal Address: NORTHPORT, AL
Registered Office Street Address: 2312 BRIDGE AVENORTHPORT, AL 35476
Registered Office Street Address ZIP Code: 35476
Authorized Capital: $10,000

Activities ANY LAWFUL ACTIVITY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1558410167 2007-01-10 2010-04-16 952 ROSE DR, NORTHPORT, AL, 354763363, US 952 ROSE DR, NORTHPORT, AL, 354763363, US

Contacts
Phone +1 205-339-8282
Fax 2083390936

Authorized person
Name MS. PAM H BROWNE
Role OFFICE MANAGER
Phone 2053398282

Taxonomy
Taxonomy Code 207R00000X - Internal Medicine Physician
License Number 12788
State AL
Is Primary Yes

Other Provider Identifiers
Issuer UNITED HEALTHCARE
Number 0410625
State AL
Issuer MEDICARE IDENTIFIER
Number H018
State AL
Issuer MEDICAID
Number 528801430
State AL
Issuer MEDICARE TRAVELERS
Number 010021562
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NORTHPORT INTERNAL MEDICINE PC PROFIT SHARING PLAN 2020 630789656 2021-09-13 NORTHPORT INTERNAL MEDICINE, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1980-04-01
Business code 621111
Sponsor’s telephone number 2053398282
Plan sponsor’s address 952 ROSE DRIVE, NORTHPORT, AL, 35476

Signature of
Role Plan administrator
Date 2021-09-13
Name of individual signing PAM BROWNE
NORTHPORT INTERNAL MEDICINE PC PROFIT SHARING PLAN 2019 630789656 2020-05-20 NORTHPORT INTERNAL MEDICINE, P.C. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1980-04-01
Business code 621111
Sponsor’s telephone number 2053398282
Plan sponsor’s address 952 ROSE DRIVE, NORTHPORT, AL, 35476

Signature of
Role Plan administrator
Date 2020-05-20
Name of individual signing PAM BROWNE
NORTHPORT INTERNAL MEDICINE PC PROFIT SHARING PLAN 2018 630789656 2019-08-19 NORTHPORT INTERNAL MEDICINE, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1980-04-01
Business code 621111
Sponsor’s telephone number 2053398282
Plan sponsor’s address 952 ROSE DRIVE, NORTHPORT, AL, 35476

Signature of
Role Plan administrator
Date 2019-08-19
Name of individual signing PAM BROWNE
NORTHPORT INTERNAL MEDICINE PC PROFIT SHARING PLAN 2017 630789656 2018-10-12 NORTHPORT INTERNAL MEDICINE, P.C. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1980-04-01
Business code 621111
Sponsor’s telephone number 2053398282
Plan sponsor’s address 952 ROSE DRIVE, NORTHPORT, AL, 35476

Signature of
Role Plan administrator
Date 2018-10-12
Name of individual signing PAM BROWNE
NORTHPORT INTERNAL MEDICINE PC PROFIT SHARING PLAN 2016 630789656 2017-10-12 NORTHPORT INTERNAL MEDICINE, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1980-04-01
Business code 621111
Sponsor’s telephone number 2053398282
Plan sponsor’s address 952 ROSE DRIVE, NORTHPORT, AL, 35476

Signature of
Role Plan administrator
Date 2017-10-12
Name of individual signing PAM BROWNE
NORTHPORT INTERNAL MEDICINE PC PROFIT SHARING PLAN 2015 630789656 2016-10-05 NORTHPORT INTERNAL MEDICINE, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1980-04-01
Business code 621111
Sponsor’s telephone number 2053398282
Plan sponsor’s address 952 ROSE DRIVE, NORTHPORT, AL, 35476

Signature of
Role Plan administrator
Date 2016-10-05
Name of individual signing PAM BROWNE
NORTHPORT INTERNAL MEDICINE PC PROFIT SHARING PLAN 2014 630789656 2015-09-14 NORTHPORT INTERNAL MEDICINE, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1980-04-01
Business code 621111
Sponsor’s telephone number 2053398282
Plan sponsor’s address 952 ROSE DRIVE, NORTHPORT, AL, 35476

Signature of
Role Plan administrator
Date 2015-09-14
Name of individual signing PAM BROWNE
NORTHPORT INTERNAL MEDICINE PC PROFIT SHARING PLAN 2013 630789656 2014-08-27 NORTHPORT INTERNAL MEDICINE, P.C. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1980-04-01
Business code 621111
Sponsor’s telephone number 2053398282
Plan sponsor’s address 952 ROSE DRIVE, NORTHPORT, AL, 35476

Signature of
Role Plan administrator
Date 2014-08-27
Name of individual signing PAM BROWNE
NORTHPORT INTERNAL MEDICINE PC PROFIT SHARING PLAN 2012 630789656 2013-09-09 NORTHPORT INTERNAL MEDICINE, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1980-04-01
Business code 621111
Sponsor’s telephone number 2053398282
Plan sponsor’s address 952 ROSE DRIVE, NORTHPORT, AL, 35476

Signature of
Role Plan administrator
Date 2013-09-09
Name of individual signing PAM BROWNE
NORTHPORT INTERNAL MEDICINE PC PROFIT SHARING PLAN 2011 630789656 2012-09-12 NORTHPORT INTERNAL MEDICINE, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1980-04-01
Business code 621111
Sponsor’s telephone number 2053398282
Plan sponsor’s address 952 ROSE DRIVE, NORTHPORT, AL, 35476

Plan administrator’s name and address
Administrator’s EIN 630789656
Plan administrator’s name NORTHPORT INTERNAL MEDICINE, P.C.
Plan administrator’s address 952 ROSE DRIVE, NORTHPORT, AL, 35476
Administrator’s telephone number 2053398282

Signature of
Role Plan administrator
Date 2012-09-12
Name of individual signing PAM BROWNE

Agent

Name Role
BOYD, HAYSE Agent

Incorporator

Name Role
BOYD, HAYSE MD Incorporator
BOYD, PEGGY R Incorporator

Events

Event Date Event Type Old Value New Value
2000-07-27 Name Change Drs. Boyd & Browne, P.C. Northport Internal Medicine, P.C.
1991-08-29 Name Change Hayse Boyd, M.D., P.A. Drs. Boyd & Browne, P.C.

Related by officers

No related officers

Related by address

NORTHPORT, AL

Anders Hardware Company Inc. Dixie Aerial Sprayers Inc. Dixie Air, Inc. Fred's of Tuscaloosa, Inc. Acorn Services, Inc. North Riviera, Incorporated North River Shores, Incorporated Park Street Electric Company, Inc. Linen Distributors, Inc. E. P. Kelley Consulting, Inc.

Date of last update: 31 Jul 2024

Sources: Alabama Secretary of State

Privacy policy Policy
About us About us
Contacts Contact us

© 2024 alabamacompanysearch.com, Part of Big Data Integrated