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American Family Care, LLC

Details

Name: American Family Care, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 03 Aug 1982 (42 years ago)
Entity Number: 000-088-161
Register Number: 000088161
Historical Names: Emergency Medicine South, Inc.
American Family Care, Inc.
County: Shelby
Place of Formation: Jefferson County
Principal Address: 3700 CAHABA BEACH ROADBIRMINGHAM, AL 35242
Principal Address ZIP Code: 35242

Activities OPERATE EMERGENCY MEDICINE FACILITIES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1740015635 2024-09-03 2024-09-03 3700 CAHABA BEACH RD, HOOVER, AL, 352425225, US 467 GREEN SPRINGS HWY, HOMEWOOD, AL, 352094921, US

Contacts
Phone +1 205-421-2151

Authorized person
Name RANDY JOHANSEN
Role CEO
Phone 2054212101

Taxonomy
Taxonomy Code 208D00000X - General Practice Physician
Is Primary No
Taxonomy Code 261QP2300X - Primary Care Clinic/Center
Is Primary Yes
Taxonomy Code 261QU0200X - Urgent Care Clinic/Center
Is Primary No

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
AMERICAN FAMILY CARE INC GROUP VISION PLAN 2011 630825248 2012-07-11 AMERICAN FAMILY CARE INC. 222
File View Page
Three-digit plan number (PN) 504
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2054038902
Plan sponsor’s mailing address 2147 RIVERCHASE OFFICE ROAD, HOOVER, AL, 35244
Plan sponsor’s address 2147 RIVERCHASE OFFICE ROAD, HOOVER, AL, 35244

Plan administrator’s name and address
Administrator’s EIN 630825248
Plan administrator’s name AMERICAN FAMILY CARE INC.
Plan administrator’s address 2147 RIVERCHASE OFFICE ROAD, HOOVER, AL, 35244
Administrator’s telephone number 2054038902

Number of participants as of the end of the plan year
Active participants 250
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
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 2012-07-11
Name of individual signing JAMES KERR
Valid signature Filed with authorized/valid electronic signature
AMERICAN FAMILY CARE LIFE AND DISABILITY INSURANCE PLANS 2011 630825248 2012-07-06 AMERICAN FAMILY CARE INC. 400
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 2054038902
Plan sponsor’s mailing address 2147 RIVERCHASE OFFICE RD., HOOVER, AL, 35244
Plan sponsor’s address 2147 RIVERCHASE OFFICE RD., HOOVER, AL, 35244

Plan administrator’s name and address
Administrator’s EIN 630825248
Plan administrator’s name AMERICAN FAMILY CARE INC.
Plan administrator’s address 2147 RIVERCHASE OFFICE RD., HOOVER, AL, 35244
Administrator’s telephone number 2054038902

Number of participants as of the end of the plan year
Active participants 442
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0

Signature of
Role Plan administrator
Date 2012-07-06
Name of individual signing JAMES KERR
Valid signature Filed with authorized/valid electronic signature
AMERICAN FAMILY CARE INC GROUP HEALTHCARE PLAN 2011 630825248 2012-07-06 AMERICAN FAMILY CARE INC. 298
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1982-08-03
Business code 621111
Sponsor’s telephone number 2054038902
Plan sponsor’s mailing address 2147 RIVERCHASE OFFICE ROAD, HOOVER, AL, 35244
Plan sponsor’s address 2147 RIVERCHASE OFFICE ROAD, HOOVER, AL, 35244

Plan administrator’s name and address
Administrator’s EIN 630825248
Plan administrator’s name AMERICAN FAMILY CARE INC.
Plan administrator’s address 2147 RIVERCHASE OFFICE ROAD, HOOVER, AL, 35244
Administrator’s telephone number 2054038902

Number of participants as of the end of the plan year
Active participants 313
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0

Signature of
Role Plan administrator
Date 2012-07-06
Name of individual signing JAMES KERR
Valid signature Filed with authorized/valid electronic signature
AMERICAN FAMILY CARE LIFE & DISABILITY INSURANCE PLANS 2010 630825248 2011-07-05 AMERICAN FAMILY CARE INC 368
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2004-11-01
Business code 621111
Sponsor’s telephone number 2054038902
Plan sponsor’s mailing address 2147 RIVERCHASE OFFICE RD., HOOVER, AL, 35244
Plan sponsor’s address 2147 RIVERCHASE OFFICE RD., HOOVER, AL, 35244

Plan administrator’s name and address
Administrator’s EIN 630825248
Plan administrator’s name AMERICAN FAMILY CARE INC
Plan administrator’s address 2147 RIVERCHASE OFFICE RD., HOOVER, AL, 35244
Administrator’s telephone number 2054038902

Number of participants as of the end of the plan year
Active participants 400
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0

Signature of
Role Plan administrator
Date 2011-07-05
Name of individual signing JAMES KERR
Valid signature Filed with authorized/valid electronic signature
AMERICAN FAMILY CARE INC GROUP HEALTHCARE PLAN 2010 630825248 2011-07-07 AMERICAN FAMILY CARE INC. 293
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1982-08-03
Business code 621111
Sponsor’s telephone number 2054038902
Plan sponsor’s mailing address 2147 RIVERCHASE OFFICE RD., HOOVER, AL, 35244
Plan sponsor’s address 2147 RIVERCHASE OFFICE RD., HOOVER, AL, 35244

Plan administrator’s name and address
Administrator’s EIN 630825248
Plan administrator’s name AMERICAN FAMILY CARE INC.
Plan administrator’s address 2147 RIVERCHASE OFFICE RD., HOOVER, AL, 35244
Administrator’s telephone number 2054038902

Number of participants as of the end of the plan year
Active participants 298
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0

Signature of
Role Plan administrator
Date 2011-07-07
Name of individual signing JAMES KERR
Valid signature Filed with authorized/valid electronic signature
AMERICAN FAMILY CARE INC GROUP VISION PLAN 2010 630825248 2011-07-05 AMERICAN FAMILY CARE INC. 193
File View Page
Three-digit plan number (PN) 504
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2054038902
Plan sponsor’s mailing address 2147 RIVERCHASE OFFICE RD., HOOVER, AL, 35244
Plan sponsor’s address 2147 RIVERCHASE OFFICE RD., HOOVER, AL, 35244

Plan administrator’s name and address
Administrator’s EIN 630825248
Plan administrator’s name AMERICAN FAMILY CARE INC.
Plan administrator’s address 2147 RIVERCHASE OFFICE RD., HOOVER, AL, 35244
Administrator’s telephone number 2054038902

Number of participants as of the end of the plan year
Active participants 222
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0

Signature of
Role Plan administrator
Date 2011-07-05
Name of individual signing JAMES KERR
Valid signature Filed with authorized/valid electronic signature
AMERICAN FAMILY CARE LIFE & DISABILITY INSURANCE PLANS 2009 630825248 2010-07-02 AMERICAN FAMILY CARE INC 328
File View Page
Three-digit plan number (PN) 503
Effective date of plan 2004-11-01
Business code 621111
Sponsor’s telephone number 2054038902
Plan sponsor’s mailing address 2147 RIVERCHASE OFFICE RD., HOOVER, AL, 35244
Plan sponsor’s address 2147 RIVERCHASE OFFICE RD., HOOVER, AL, 35244

Plan administrator’s name and address
Administrator’s EIN 630825248
Plan administrator’s name AMERICAN FAMILY CARE INC
Plan administrator’s address 2147 RIVERCHASE OFFICE RD., HOOVER, AL, 35244
Administrator’s telephone number 2054038902

Number of participants as of the end of the plan year
Active participants 367
Retired or separated participants receiving benefits 1
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0

Signature of
Role Plan administrator
Date 2010-07-02
Name of individual signing JAMES KERR
Valid signature Filed with authorized/valid electronic signature
AMERICAN FAMILY CARE INC GROUP HEALTHCARE PLAN 2009 630825248 2010-07-02 AMERICAN FAMILY CARE INC. 244
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1982-08-03
Business code 621111
Sponsor’s telephone number 2054038902
Plan sponsor’s mailing address 2147 RIVERCHASE OFFICE RD., HOOVER, AL, 35244
Plan sponsor’s address 2147 RIVERCHASE OFFICE RD., HOOVER, AL, 35244

Plan administrator’s name and address
Administrator’s EIN 630825248
Plan administrator’s name AMERICAN FAMILY CARE INC.
Plan administrator’s address 2147 RIVERCHASE OFFICE RD., HOOVER, AL, 35244
Administrator’s telephone number 2054038902

Number of participants as of the end of the plan year
Active participants 293
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0

Signature of
Role Plan administrator
Date 2010-07-02
Name of individual signing JAMES KERR
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
RANDY JOHANSEN Agent

Incorporator

Name Role Address
IRWIN, D BRUCE Incorporator 2147 RIVERCHASE OFFICE ROADHOOVER, AL 35244
BLAKE, JAMES D Incorporator 1636 BUTTE WOODS DRIVEBIRMINGHAM, AL 35242

Organizer

Name Role Address
KATHERINE A. MCCLINTOCK Organizer 1100 PEACHTREE ST NE # 2800ATLANTA, GA 30309

Events

Event Date Event Type Old Value New Value
2023-02-06 Name Change American Family Care, Inc. American Family Care, LLC
2012-12-28 Capital Change $8,000 Authorized $4,000 Paid In undefined Authorized undefined Paid In
1984-11-29 Name Change Emergency Medicine South, Inc. American Family Care, Inc.

Related by officers

IRWIN, D BRUCE

Emergency Medicine South, P.C. Goodyear Shoe Hospital, Inc. Nuclear Pharmacies, Inc. American Family Care Florida, LLC AFC Holdings, LLC

BLAKE, JAMES D

Emergency Medicine South, P.C. Hoover Medicine, Inc. Be Well Medical PC, LLC

Related by address

3700 CAHABA BEACH ROADBIRMINGHAM, AL 35242

American Family Care Georgia, LLC AFC Providers, LLC DBI PROPERTIES - WADE WOOD BUILDING, LLC AFC Purchasing, LLC DBI Properties - Oxford, LLC DBI Marine, LLC DBI Aviation, LLC DRJ Sterling Breeze Investments, LLC American Family Care/Tennessee, LLC

Date of last update: 31 Jul 2024

Sources: Alabama Secretary of State

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