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Tuscaloosa Pediatrics, P.C.

Details

Name: Tuscaloosa Pediatrics, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 01 Oct 1987 (37 years ago)
Entity Number: 000-119-805
Register Number: 000119805
County: Tuscaloosa
Place of Formation: Tuscaloosa County
Registered Office Street Address: 535 RIVER RD E STE C RIVERSIDE MEDICAL CENTERTUSCALOOSA, AL 35405
Registered Office Street Address ZIP Code: 35405
Authorized Capital: $5,000

Activities PEDIATRIC MEDICINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1710072798 2006-10-04 2020-07-10 4880 HARKEY LN, TUSCALOOSA, AL, 354062863, US 4880 HARKEY LN, TUSCALOOSA, AL, 354062863, US

Contacts
Phone +1 205-333-8222
Fax 2053338233

Authorized person
Name MRS. DENISE BROWN
Role PHYSICIAN
Phone 2053338222

Taxonomy
Taxonomy Code 208000000X - Pediatrics Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TUSCALOOSA PEDIATRICS P.C. 401(K) PLAN 2018 630962149 2019-06-19 TUSCALOOSA PEDIATRICS P.C. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-02-01
Business code 621111
Sponsor’s telephone number 2053338222
Plan sponsor’s address 657 HELEN KELLER BOULEVARD, TUSCALOOSA, AL, 35404

Signature of
Role Plan administrator
Date 2019-06-19
Name of individual signing DENISE BROWN
Role Employer/plan sponsor
Date 2019-06-19
Name of individual signing DENISE BROWN
TUSCALOOSA PEDIATRICS P.C. 401(K) PLAN 2017 630962149 2018-05-21 TUSCALOOSA PEDIATRICS P.C. 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-02-01
Business code 621111
Sponsor’s telephone number 2053338222
Plan sponsor’s address 657 HELEN KELLER BOULEVARD, TUSCALOOSA, AL, 35404

Signature of
Role Plan administrator
Date 2018-05-07
Name of individual signing MILICENT YEAGER
Role Employer/plan sponsor
Date 2018-05-21
Name of individual signing DENISE BROWN MD
TUSCALOOSA PEDIATRICS P.C. 401(K) PLAN 2016 630962149 2017-07-16 TUSCALOOSA PEDIATRICS P.C. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-02-01
Business code 621111
Sponsor’s telephone number 2053338222
Plan sponsor’s address 657 HELEN KELLER BOULEVARD, TUSCALOOSA, AL, 35404

Signature of
Role Plan administrator
Date 2017-07-16
Name of individual signing DENISE BROWN
Role Employer/plan sponsor
Date 2017-07-16
Name of individual signing TUSCALOOSA PEDIATRICS PC
TUSCALOOSA PEDIATRICS P.C. 401(K) PLAN 2015 630962149 2016-08-22 TUSCALOOSA PEDIATRICS P.C. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-02-01
Business code 621111
Sponsor’s telephone number 2053338222
Plan sponsor’s address 657 HELEN KELLER BOULEVARD, TUSCALOOSA, AL, 35404

Signature of
Role Plan administrator
Date 2016-08-22
Name of individual signing DENISE BROWN
TUSCALOOSA PEDIATRICS P.C. 401(K) PLAN 2014 630962149 2015-06-20 TUSCALOOSA PEDIATRICS P.C. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-02-01
Business code 621391
Sponsor’s telephone number 2053338222
Plan sponsor’s address 657 HELEN KELLER BLVD, TUSCALOOSA, AL, 35404

Signature of
Role Plan administrator
Date 2015-06-20
Name of individual signing DR DENISE BROWN
Role Employer/plan sponsor
Date 2015-06-20
Name of individual signing DR DENISE BROWN
TUSCALOOSA PEDIATRICS P.C. 401(K) PLAN 2013 630962149 2014-09-19 TUSCALOOSA PEDIATRICS P.C. 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-02-01
Business code 621391
Sponsor’s telephone number 2053338222
Plan sponsor’s address 657 HELEN KELLER BLVD, TUSCALOOSA, AL, 35404

Signature of
Role Plan administrator
Date 2014-09-19
Name of individual signing DENISE NELSON BROWN MD
TUSCALOOSA PEDIATRICS P.C. 401(K) PLAN 2012 630962149 2013-09-04 TUSCALOOSA PEDIATRICS P.C. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-02-01
Business code 621391
Sponsor’s telephone number 2053338222
Plan sponsor’s address 657 HELEN KELLER BLVD, TUSCALOOSA, AL, 35404

Signature of
Role Plan administrator
Date 2013-09-04
Name of individual signing DENISE NELSON BROWN MD
Role Employer/plan sponsor
Date 2013-09-04
Name of individual signing DENISE NELSON BROWN MD
TUSCALOOSA PEDIATRICS P.C. 401(K) PLAN 2011 630962149 2012-07-21 TUSCALOOSA PEDIATRICS P.C. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-02-01
Business code 621391
Sponsor’s telephone number 2053338222
Plan sponsor’s address 657 HELEN KELLER BLVD, TUSCALOOSA, AL, 35404

Plan administrator’s name and address
Administrator’s EIN 630962149
Plan administrator’s name TUSCALOOSA PEDIATRICS P.C.
Plan administrator’s address 657 HELEN KELLER BLVD, TUSCALOOSA, AL, 35404
Administrator’s telephone number 2053338222

Signature of
Role Plan administrator
Date 2012-07-21
Name of individual signing DENISE BROWN
TUSCALOOSA PEDIATRICS P.C. 401(K) PLAN 2010 630962149 2011-06-10 TUSCALOOSA PEDIATRICS P.C. 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-02-01
Business code 621391
Sponsor’s telephone number 2053338222
Plan sponsor’s address 657 HELEN KELLER BLVD, TUSCALOOSA, AL, 35404

Plan administrator’s name and address
Administrator’s EIN 630962149
Plan administrator’s name TUSCALOOSA PEDIATRICS P.C.
Plan administrator’s address 657 HELEN KELLER BLVD, TUSCALOOSA, AL, 35404
Administrator’s telephone number 2053338222

Signature of
Role Plan administrator
Date 2011-06-10
Name of individual signing DENISE BROWN

Agent

Name Role
PALMER, JERRY M MD Agent

Incorporator

Name Role
PALMER, JERRY M MD Incorporator

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 31 Jul 2024

Sources: Alabama Secretary of State

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