| Name: | Anesthesia Consultants Medical Group, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 19 Jan 1990 (35 years ago) |
| Entity Number: | 000-135-120 |
| Register Number: | 000135120 |
| County: | Houston |
| Place of Formation: | Houston County |
| Registered Office Street Address: | 1600 EAST MAIN STR.DOTHAN, AL 36301 |
| Registered Office Street Address ZIP Code: | 36301 |
| Registered Office Mailing Address: | P.O. BOX 1546DOTHAN, AL 36302 |
| Registered Office Mailing Address ZIP Code: | 36302 |
| Authorized Capital: | $1,200 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANESTHESIA CONSULTANTS MEDICAL GROUP, P.C. MPPP | 2011 | 631012508 | 2012-07-19 | ANESTHESIA CONSULTANTS MEDICAL GROUP, P.C. | 11 | |||||||||||||||||||||||||||||
|
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| Administrator’s EIN | 631012508 |
| Plan administrator’s name | ANESTHESIA CONSULTANTS MEDICAL GROU |
| Plan administrator’s address | 1118 ROSS CLARK CIRCLE, SUITE 700, DOTHAN, AL, 36301 |
| Administrator’s telephone number | 3347935105 |
Signature of
| Role | Plan administrator |
| Date | 2012-07-18 |
| Name of individual signing | RALPH B FILLMORE |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 1994-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3347935105 |
| Plan sponsor’s address | 1118 ROSS CLARK CIRCLE, SUITE 700, DOTHAN, AL, 36301 |
Plan administrator’s name and address
| Administrator’s EIN | 631012508 |
| Plan administrator’s name | ANESTHESIA CONSULTANTS MEDICAL GROU |
| Plan administrator’s address | 1118 ROSS CLARK CIRCLE, SUITE 700, DOTHAN, AL, 36301 |
| Administrator’s telephone number | 3347935105 |
Signature of
| Role | Plan administrator |
| Date | 2011-08-24 |
| Name of individual signing | RALPH B FILLMORE |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 1994-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3347935105 |
| Plan sponsor’s address | 1118 ROSS CLARK CIRCLE, SUITE 700, DOTHAN, AL, 36301 |
Plan administrator’s name and address
| Administrator’s EIN | 631012508 |
| Plan administrator’s name | ANESTHESIA CONSULTANTS MEDICAL GROU |
| Plan administrator’s address | 1118 ROSS CLARK CIRCLE, SUITE 700, DOTHAN, AL, 36301 |
| Administrator’s telephone number | 3347935105 |
Signature of
| Role | Plan administrator |
| Date | 2010-10-06 |
| Name of individual signing | RALPH B FILLMORE |
| Name | Role |
|---|---|
| FILLMORE M D, RALPH B | Agent |
| Name | Role |
|---|---|
| FILLMORE M D, RALPH B | Incorporator |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PO | AWARD | DJBMNAIVB231397 | 2009-08-12 | 2009-08-12 | 2009-09-30 | |||||||||||||||||||||
|
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| Title | ANESTHESIA SERVICES |
| NAICS Code | 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS) |
| Product and Service Codes | Q501: ANESTHESIOLOGY SERVICES |
Recipient Details
| Recipient | ANESTHESIA CONSULTANTS MEDICAL GROUP, P.C. |
| UEI | Q329FSSZ72C7 |
| Legacy DUNS | 841767825 |
| Recipient Address | UNITED STATES, 1118 ROSS CLARK CIR # 700, DOTHAN, 363013001 |
| Unique Award Key | CONT_AWD_DJBMNAIVB230332_1540_-NONE-_-NONE- |
| Awarding Agency | Department of Justice |
| Link | View Page |
Description
| Title | ANESTHESIA SERVICES |
| NAICS Code | 622310: SPECIALTY (EXCEPT PSYCHIATRIC AND SUBSTANCE ABUSE) HOSPITALS |
| Product and Service Codes | Q501: ANESTHESIOLOGY SERVICES |
Recipient Details
| Recipient | ANESTHESIA CONSULTANTS MEDICAL GROUP, P.C. |
| UEI | Q329FSSZ72C7 |
| Legacy DUNS | 841767825 |
| Recipient Address | UNITED STATES, 1118 ROSS CLARK CIR # 700, DOTHAN, 363013001 |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
