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Eastern Shore Physical Therapy, Inc.

Details

Name: Eastern Shore Physical Therapy, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Exists
Date of registration: 24 Mar 1989 (36 years ago) (Companies founded in March 1989)
Entity Number: 000-130-552
Register Number: 000130552
ZIP code: 36527 (Companies in Baldwin, 36527)
County: Baldwin
Place of Formation: Baldwin County
Principal Address: SPANISH FORT, AL
Registered Office Street Address: 14 PIRATES LANESPANISH FORT, AL 36527
Authorized Capital: $1,000
Paid Share Capital: $1,000

Activities OUTPATIENT CLINICAL SETTING

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1700831666 2006-05-22 2023-04-25 PO BOX 2463, DAPHNE, AL, 365262463, US 6475 VAN BUREN ST, SUITE 102, DAPHNE, AL, 365267585, US

Contacts
Phone +1 251-626-9052
Fax 2516265384

Authorized person
Name MCKENZIE JONES
Role CO-OWNER/PRESIDENT
Phone 2516269052

Taxonomy
Taxonomy Code 261QP2000X - Physical Therapy Clinic/Center
License Number PTH847
State AL
Is Primary Yes

Other Provider Identifiers
Issuer RAIL ROAL MEDICARE
Number CL2210
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EASTERN SHORE PHYSICAL THERAPY,INC 401K PLAN 2020 630997518 2021-07-19 EASTERN SHORE PHYSICAL THERAPY, INC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621340
Sponsor’s telephone number 2516269052
Plan sponsor’s address 6475 VAN BUREN ST STE 102, DAPHNE, AL, 365267571

Signature of
Role Plan administrator
Date 2021-07-19
Name of individual signing RUTH AUBREY
Role Employer/plan sponsor
Date 2021-07-19
Name of individual signing RUTH AUBREY
EASTERN SHORE PHYSICAL THERAPY,INC 401K PLAN 2020 630997518 2021-04-16 EASTERN SHORE PHYSICAL THERAPY, INC 7
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621340
Sponsor’s telephone number 2516269052
Plan sponsor’s address 6475 VAN BUREN ST STE 102, DAPHNE, AL, 365267571

Signature of
Role Plan administrator
Date 2021-04-16
Name of individual signing RUTH AUBREY
Role Employer/plan sponsor
Date 2021-04-16
Name of individual signing RUTH AUBREY
EASTERN SHORE PHYSICAL THERAPY INC. 401K PLAN 2017 630997518 2018-03-26 EASTERN SHORE PHYSICAL THERAPY INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621340
Sponsor’s telephone number 2516269052
Plan sponsor’s address 6475 VAN BUREN ST. STE 102, DAPHNE, AL, 36526

Signature of
Role Plan administrator
Date 2018-03-26
Name of individual signing RUTH N AUBREY
Role Employer/plan sponsor
Date 2018-03-26
Name of individual signing RUTH N AUBREY
EASTERN SHORE PHYSICAL THERAPY INC. 401K PLAN 2016 630997518 2017-07-26 EASTERN SHORE PHYSICAL THERAPY INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621340
Sponsor’s telephone number 2516269052
Plan sponsor’s address 6475 VAN BUREN ST. STE 102, DAPHNE, AL, 36526

Signature of
Role Plan administrator
Date 2017-07-26
Name of individual signing RUTH N AUBREY
Role Employer/plan sponsor
Date 2017-07-26
Name of individual signing RUTH N AUBREY
EASTERN SHORE PHYSICAL THERAPY INC. 401K PLAN 2015 630997518 2016-06-14 EASTERN SHORE PHYSICAL THERAPY INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621340
Sponsor’s telephone number 2516269052
Plan sponsor’s address 6475 VAN BUREN ST. STE 102, DAPHNE, AL, 36526

Signature of
Role Plan administrator
Date 2016-06-14
Name of individual signing RUTH N AUBREY
Role Employer/plan sponsor
Date 2016-06-14
Name of individual signing RUTH N AUBREY
EASTERN SHORE PHYSICAL THERAPY INC. 401K PLAN 2014 630997518 2015-10-01 EASTERN SHORE PHYSICAL THERAPY INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621340
Sponsor’s telephone number 2516269052
Plan sponsor’s address 6475 VAN BUREN ST. STE 102, DAPHNE, AL, 36526

Signature of
Role Plan administrator
Date 2015-09-27
Name of individual signing RUTH N AUBREY
Role Employer/plan sponsor
Date 2015-09-27
Name of individual signing RUTH N AUBREY
EASTERN SHORE PHYSICAL THERAPY INC. 401K PLAN 2013 630997518 2014-05-14 EASTERN SHORE PHYSICAL THERAPY INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621340
Sponsor’s telephone number 2516269052
Plan sponsor’s address P.O. BOX 7520, SPANISH FORT, AL, 36577

Plan administrator’s name and address
Administrator’s EIN 630997518
Plan administrator’s name RUTH N AUBREY
Plan administrator’s address P.O. BOX 7520, SPANISH FORT, AL, 36577
Administrator’s telephone number 2516269052

Signature of
Role Plan administrator
Date 2014-05-14
Name of individual signing RUTH N AUBREY
Role Employer/plan sponsor
Date 2014-05-14
Name of individual signing RUTH N AUBREY
EASTERN SHORE PHYSICAL THERAPY INC. 401K PLAN 2012 630997518 2013-10-15 EASTERN SHORE PHYSICAL THERAPY INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621340
Sponsor’s telephone number 2516269052
Plan sponsor’s address P.O. BOX 7520, SPANISH FORT, AL, 36577

Plan administrator’s name and address
Administrator’s EIN 630997518
Plan administrator’s name RUTH N AUBREY
Plan administrator’s address P.O. BOX 7520, SPANISH FORT, AL, 36577
Administrator’s telephone number 2516269052

Signature of
Role Plan administrator
Date 2013-10-15
Name of individual signing RUTH N AUBREY
Role Employer/plan sponsor
Date 2013-10-15
Name of individual signing RUTH N AUBREY
EASTERN SHORE PHYSICAL THERAPY INC. 401K PLAN 2011 630997518 2013-10-23 EASTERN SHORE PHYSICAL THERAPY INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621340
Sponsor’s telephone number 2516269052
Plan sponsor’s address P.O. BOX 7520, SPANISH FORT, AL, 36577

Plan administrator’s name and address
Administrator’s EIN 630997518
Plan administrator’s name EASTERN SHORE PHYSICAL THERAPY INC.
Plan administrator’s address P.O. BOX 7520, SPANISH FORT, AL, 36577
Administrator’s telephone number 2516269052

Signature of
Role Plan administrator
Date 2013-10-22
Name of individual signing RUTH AUBREY
Role Employer/plan sponsor
Date 2013-10-22
Name of individual signing RUTH AUBREY
EASTERN SHORE PHYSICAL THERAPY INC. 401K PLAN 2010 630997518 2011-09-30 EASTERN SHORE PHYSICAL THERAPY INC. 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621340
Sponsor’s telephone number 2516269052
Plan sponsor’s address P.O. BOX 7520, SPANISH FORT, AL, 36577

Plan administrator’s name and address
Administrator’s EIN 630997518
Plan administrator’s name EASTERN SHORE PHYSICAL THERAPY INC.
Plan administrator’s address P.O. BOX 7520, SPANISH FORT, AL, 36577
Administrator’s telephone number 2516269052

Signature of
Role Plan administrator
Date 2011-09-22
Name of individual signing RUTH AUBREY
Role Employer/plan sponsor
Date 2011-09-22
Name of individual signing RUTH AUBREY

Agent

Name Role
AUBREY, RUTH N Agent

Incorporator

Name Role
AUBREY, ROGER D Incorporator
AUBREY, RUTH N Incorporator

Related by officers

AUBREY, ROGER D

Aubrey's Enterprises, Inc.

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Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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