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Thomas D. Bianchi, M.D., P.A.

Details

Name: Thomas D. Bianchi, M.D., P.A.
Jurisdiction: Alabama
Legal type: Domestic Professional Association
Status: Exists
Date of registration: 13 Oct 1981 (43 years ago)
Entity Number: 000-064-541
Register Number: 000064541
County: Elmore
Place of Formation: Elmore County
Principal Address: 80 HERREN HILL RD STE 3TALLASSEE, AL 36078
Principal Address ZIP Code: 36078

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1740484211 2007-06-11 2011-06-13 80 HERREN HILL RD, SUITE E, TALLASSEE, AL, 360781263, US 80 HERREN HILL RD, SUITE E, TALLASSEE, AL, 360781263, US

Contacts
Phone +1 334-283-3862
Fax 3342833871

Authorized person
Name DR. THOMAS D BIANCHI
Role OWNER
Phone 3342833862

Taxonomy
Taxonomy Code 207RG0100X - Gastroenterology Physician
License Number 8344
State AL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 529912510
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
THOMAS D BIANCHI, MDPA 401 (K) PROFIT SHARING PLAN 2023 630814376 2024-10-14 THOMAS D. BIANCHI, M.D., P.A. 6
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 3342833111
Plan sponsor’s address 80 HERREN HILL ROAD, SUITE E, TALLASSEE, AL, 36078

Signature of
Role Plan administrator
Date 2024-10-14
Name of individual signing THOMAS D. BIANCHI, M.D.
Valid signature Filed with authorized/valid electronic signature
THOMAS D BIANCHI, MDPA 401 (K) PROFIT SHARING PLAN 2022 630814376 2023-10-12 THOMAS D. BIANCHI, M.D., P.A. 6
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 3342833111
Plan sponsor’s address 80 HERREN HILL ROAD, SUITE E, TALLASSEE, AL, 36078

Signature of
Role Plan administrator
Date 2023-10-11
Name of individual signing THOMAS D. BIANCHI, M.D.
THOMAS D BIANCHI, MDPA 401 (K) PROFIT SHARING PLAN 2021 630814376 2022-10-17 THOMAS D. BIANCHI, M.D., P.A. 5
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 3342833111
Plan sponsor’s address 80 HERREN HILL ROAD, SUITE E, TALLASSEE, AL, 36078

Signature of
Role Plan administrator
Date 2022-10-17
Name of individual signing THOMAS D. BIANCHI, M.D.
THOMAS D BIANCHI, MDPA 401 (K) PROFIT SHARING PLAN 2020 630814376 2021-10-11 THOMAS D. BIANCHI, M.D., P.A. 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 3342833111
Plan sponsor’s address 80 HERREN HILL ROAD, SUITE E, TALLASSEE, AL, 36078

Signature of
Role Plan administrator
Date 2021-10-11
Name of individual signing THOMAS D. BIANCHI, M.D.
Role Employer/plan sponsor
Date 2021-10-11
Name of individual signing THOMAS D. BIANCHI, M.D.
THOMAS D BIANCHI, MDPA 401 (K) PROFIT SHARING PLAN 2019 630814376 2020-10-13 THOMAS D. BIANCHI, M.D., P.A. 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 3342833111
Plan sponsor’s address 80 HERREN HILL ROAD, SUITE E, TALLASSEE, AL, 36078

Signature of
Role Plan administrator
Date 2020-10-07
Name of individual signing THOMAS D. BIANCHI, M.D.
Role Employer/plan sponsor
Date 2020-10-07
Name of individual signing THOMAS D. BIANCHI, M.D.
THOMAS D BIANCHI, MDPA 401 (K) PROFIT SHARING PLAN 2018 630814376 2019-10-09 THOMAS D. BIANCHI, M.D., P.A. 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 3342833111
Plan sponsor’s address 80 HERREN HILL ROAD, SUITE E, TALLASSEE, AL, 36078

Signature of
Role Plan administrator
Date 2019-10-09
Name of individual signing THOMAS D. BIANCHI, M.D.
Role Employer/plan sponsor
Date 2019-10-09
Name of individual signing THOMAS D. BIANCHI, M.D.
THOMAS D BIANCHI, MDPA 401 (K) PROFIT SHARING PLAN 2017 630814376 2018-10-08 THOMAS D. BIANCHI, M.D., P.A. 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 3342833111
Plan sponsor’s address 80 HERREN HILL ROAD, SUITE E, TALLASSEE, AL, 36078

Signature of
Role Plan administrator
Date 2018-10-08
Name of individual signing THOMAS D. BIANCHI, M.D.
Role Employer/plan sponsor
Date 2018-10-08
Name of individual signing THOMAS D. BIANCHI, M.D.
THOMAS D BIANCHI, MDPA 401 (K) PROFIT SHARING PLAN 2016 630814376 2017-08-18 THOMAS D. BIANCHI, M.D., P.A. 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 3342833111
Plan sponsor’s address 80 HERREN HILL ROAD, SUITE E, TALLASSEE, AL, 36078

Signature of
Role Plan administrator
Date 2017-08-17
Name of individual signing THOMAS D. BIANCHI, M.D.
Role Employer/plan sponsor
Date 2017-08-17
Name of individual signing THOMAS D. BIANCHI, M.D.
THOMAS D BIANCHI, MDPA 401 (K) PROFIT SHARING PLAN 2015 630814376 2016-10-10 THOMAS D. BIANCHI, M.D., P.A. 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 3342833111
Plan sponsor’s address 80 HERREN HILL ROAD, SUITE E, TALLASSEE, AL, 36078

Signature of
Role Plan administrator
Date 2016-10-07
Name of individual signing THOMAS D. BIANCHI, M.D.
Role Employer/plan sponsor
Date 2016-10-07
Name of individual signing THOMAS D. BIANCHI, M.D.
THOMAS D BIANCHI MDPA 401 K PROFIT SHARING PLAN 2014 630814376 2015-10-12 THOMAS D. BIANCHI, M.D., P.A. 7
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1991-01-01
Business code 621111
Sponsor’s telephone number 3342833111
Plan sponsor’s address 80 HERREN HILL ROAD, SUITE E, TALLASSEE, AL, 36078

Signature of
Role Plan administrator
Date 2015-10-12
Name of individual signing THOMAS D. BIANCHI, M.D.
Role Employer/plan sponsor
Date 2015-10-12
Name of individual signing THOMAS D. BIANCHI, M.D.

Member

Name Role
BIANCHI, THOMAS D MD Member

Related by officers

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Date of last update: 31 Jul 2024

Sources: Alabama Secretary of State

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