| Name: | Medical Associates of the Shoals, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 25 Apr 1986 (39 years ago) (Companies founded in April 1986) |
| Entity Number: | 000-110-119 |
| Register Number: | 000110119 |
| Historical Names: |
Jack M. McLendon Jr. M.D., P.C.
|
| ZIP code: | 35660 (Companies in Colbert, 35660) |
| County: | Colbert |
| Place of Formation: | Colbert County |
| Registered Office Street Address: | 1120 S. JACKSON HWY., SUITE 300SHEFFIELD, AL 35660 |
| Authorized Capital: | 1000 @ $1.00 PV |
Activities
MEDICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093881468 | 2006-11-28 | 2019-04-10 | 1120 S JACKSON HWY STE 300, SHEFFIELD, AL, 356605773, US | 1120 S JACKSON HWY STE 300, SHEFFIELD, AL, 356605773, US | |||||||||||||||||||
|
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| Phone | +1 256-383-4447 |
| Fax | 2563817999 |
Authorized person
| Name | DR. JOSHUA VACIK |
| Role | PHYSICIAN |
| Phone | 2563834447 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | No |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MEDICAL ASSOCIATES OF THE SHOALS PC 401K PSP | 2022 | 630923366 | 2024-01-22 | MEDICAL ASSOCIATES OF THE SHOALS, P C | 108 | |||||||||||||||||||||||||||||
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| Administrator’s EIN | 630923366 |
| Plan administrator’s name | MEDICAL ASSOCIATES OF THE SHOALS, PC |
| Plan administrator’s address | 1120 SOUTH JACKSON HIGHWAY, SUITE 300, SHEFFIELD, AL, 35660 |
| Administrator’s telephone number | 2053861120 |
Signature of
| Role | Plan administrator |
| Date | 2024-01-22 |
| Name of individual signing | DANIELLE MCDEAVITT |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1986-07-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2053861120 |
| Plan sponsor’s address | 203 AVALON AVENUE, SUITE 150, MUSCLE SHOALS, AL, 35661 |
Plan administrator’s name and address
| Administrator’s EIN | 630923366 |
| Plan administrator’s name | MEDICAL ASSOCIATES OF THE SHOALS, P C |
| Plan administrator’s address | 203 AVALON AVENUE, SUITE 150, MUSCLE SHOALS, AL, 35661 |
| Administrator’s telephone number | 2053861120 |
Signature of
| Role | Plan administrator |
| Date | 2011-04-11 |
| Name of individual signing | KAREN WOOD |
| Name | Role |
|---|---|
| JOSHUA D. VACIK, M.D. | Agent |
| Name | Role | Address |
|---|---|---|
| MCLENDON, JACK M JR | Director | 1100 S JACKSON HWY STE 150SHEFFIELD, AL 35660 |
| POUNDERS, RANDY M | Director | 1100 S JACKSON HWY STE 150SHEFFIELD, AL 35660 |
| MCANALLEY, J BRAD | Director | 1100 S JACKSON HWY STE 150SHEFFIELD, AL 35660 |
| VACIK, JOSHUA D | Director | 1100 S JACKSON HWY STE 150SHEFFIELD, AL 35660 |
| Name | Role |
|---|---|
| MCLENDON, JACK M JR MD | Incorporator |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2011-11-08 | Capital Change | $300 Authorized --- Paid In | 1000 @ $1.00 PV Authorized undefined Paid In |
| 1998-12-22 | Name Merged | No data | William M. Reid, M.D., P.C. |
| 1998-12-22 | Capital Change | $100 Authorized --- Paid In | $300 Authorized --- Paid In |
| 1995-07-12 | Name Change | Jack M. McLendon Jr. M.D., P.C. | Medical Associates of the Shoals, P.C. |
Date of last update: 31 Jul 2024
Sources: Alabama Secretary of State
