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Three Notch Medical Center, P.C.

Details

Name: Three Notch Medical Center, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 21 Dec 1984 (40 years ago)
Entity Number: 000-101-506
Register Number: 000101506
County: Covington
Place of Formation: Covington County
Principal Address: ANDALUSIA, AL
Registered Office Street Address: 835 SOUTH THREE NOTCH STANDALUSIA, AL 36420
Registered Office Street Address ZIP Code: 36420
Authorized Capital: $5,000

Activities MEDICAL CARE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1942226220 2006-07-13 2018-02-27 PO BOX 940, ANDALUSIA, AL, 364201218, US 835 S THREE NOTCH ST, ANDALUSIA, AL, 364205321, US

Contacts

Phone +1 334-222-8421
Fax 3382221248

Authorized person

Name DR. JOHN F MADDOX
Role PRESIDENT
Phone 3342228421

Taxonomy

Taxonomy Code 207Q00000X - Family Medicine Physician
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 529200490
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
THREE NOTCH MEDICAL CENTER, P.C. 401(K) PROFIT SHARING PLAN 2023 630890070 2024-08-15 THREE NOTCH MEDICAL CENTER, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621498
Sponsor’s telephone number 3342228421
Plan sponsor’s address PERSONAL AND CONFIDENTIAL 835 S THR, ANDALUSIA, AL, 364205321

Signature of

Role Plan administrator
Date 2024-08-15
Name of individual signing TERESA MADDOX
THREE NOTCH MEDICAL CENTER, P.C. 401(K) PROFIT SHARING PLAN 2022 630890070 2024-08-15 THREE NOTCH MEDICAL CENTER, P.C. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 3342228421
Plan sponsor’s address 835 S THREE NOTCH ST, ANDALUSIA, AL, 364205321

Signature of

Role Plan administrator
Date 2024-08-15
Name of individual signing TERESA MADDOX
THREE NOTCH MEDICAL CENTER, P.C. 401(K) PROFIT SHARING PLAN 2022 630890070 2023-10-13 THREE NOTCH MEDICAL CENTER, P.C. 15
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 3342228421
Plan sponsor’s address 835 S THREE NOTCH ST, ANDALUSIA, AL, 364205321

Signature of

Role Plan administrator
Date 2023-10-13
Name of individual signing TERESA MADDOX
THREE NOTCH MEDICAL CENTER, P.C. 401(K) PROFIT SHARING PLAN 2021 630890070 2022-07-21 THREE NOTCH MEDICAL CENTER, P.C. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 3342228421
Plan sponsor’s address 835 SOUTH THREE NOTCH STREET, ANDALUSIA, AL, 36420

Signature of

Role Plan administrator
Date 2022-07-21
Name of individual signing TERESA MADDOX
Role Employer/plan sponsor
Date 2022-07-21
Name of individual signing TERESA MADDOX
THREE NOTCH MEDICAL CENTER, P.C. 401(K) PROFIT SHARING PLAN 2020 630890070 2021-08-30 THREE NOTCH MEDICAL CENTER, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 3342228421
Plan sponsor’s address 835 SOUTH THREE NOTCH STREET, ANDALUSIA, AL, 36420

Signature of

Role Plan administrator
Date 2021-08-30
Name of individual signing TERESA MADDOX
THREE NOTCH MEDICAL CENTER, P.C. 401(K) PROFIT SHARING PLAN 2019 630890070 2020-07-08 THREE NOTCH MEDICAL CENTER, P.C. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 3342228421
Plan sponsor’s address 835 S THREE NOTCH ST, ANDALUSIA, AL, 36420

Signature of

Role Plan administrator
Date 2020-07-08
Name of individual signing TERESA MADDOX
THREE NOTCH MEDICAL CENTER, P.C. 401(K) PROFIT SHARING PLAN 2018 630890070 2019-10-03 THREE NOTCH MEDICAL CENTER, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 3342228421
Plan sponsor’s address 835 SOUTH THREE NOTCH STREET, ANDALUSIA, AL, 36420

Signature of

Role Plan administrator
Date 2019-10-03
Name of individual signing TERESA MADDOX
THREE NOTCH MEDICAL CENTER, P.C. 401(K) PROFIT SHARING PLAN 2017 630890070 2018-06-26 THREE NOTCH MEDICAL CENTER, P.C. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 3342228421
Plan sponsor’s address 835 SOUTH THREE NOTCH STREET, ANDALUSIA, AL, 36420

Signature of

Role Plan administrator
Date 2018-06-26
Name of individual signing TERESA MADDOX
THREE NOTCH MED CENTER 401K PS PLAN 2016 630890070 2017-06-19 THREE NOTCH MEDICAL CENTER, P.C. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 3342228421
Plan sponsor’s address 835 S THREE NOTCH ST, ANDALUSIA, AL, 36420

Signature of

Role Plan administrator
Date 2017-06-19
Name of individual signing TERESA MADDOX
THREE NOTCH MED CENTER 401K PS PLAN 2015 630890070 2016-06-20 THREE NOTCH MEDICAL CENTER, P.C. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 3342228421
Plan sponsor’s address 835 S THREE NOTCH ST, ANDALUSIA, AL, 36420

Signature of

Role Plan administrator
Date 2016-06-20
Name of individual signing JOHN MADDOX

Agent

Name Role
MADDOX, J F Agent

Incorporator

Name Role
JOHNSON, J W Incorporator
MADDOX, J F Incorporator

Date of last update: 31 Jul 2024

Sources: Alabama Secretary of State