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Obstetrics & Gynecology Associates of Northwest Alabama, P.C.

Details

Name: Obstetrics & Gynecology Associates of Northwest Alabama, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 02 Jan 1992 (33 years ago)
Entity Number: 000-146-969
Register Number: 000146969
County: Lauderdale
Place of Formation: Lauderdale County
Principal Address: FLORENCE, AL
Registered Office Street Address: 421 W COLLEGE STFLORENCE, AL 35630
Registered Office Street Address ZIP Code: 35630
Authorized Capital: $12
Paid Share Capital: --

Activities PHYSICIAN

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1578669081 2006-09-15 2010-06-10 2407 HELTON DR, FLORENCE, AL, 356301067, US 2407 HELTON DR, FLORENCE, AL, 356301067, US

Contacts

Phone +1 256-718-5900
Fax 2567185918

Authorized person

Name RITA KAY KIRCHLER
Role PRESIDENT
Phone 2567185900

Taxonomy

Taxonomy Code 207V00000X - Obstetrics & Gynecology Physician
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number GR#528601870
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
OBSTETRICS & GYNECOLOGY ASSOCIATES OF NORTHWEST ALABAMA, P.C. 401(K) PROFIT SHARING PLAN 2022 630816549 2023-06-14 OBSTETRICS & GYNECOLOGY ASSOCIATES OF NORTHWEST ALABAMA, P.C. 88
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 2567185920
Plan sponsor’s address 2407 HELTON DRIVE, FLORENCE, AL, 35630

Signature of

Role Plan administrator
Date 2023-06-14
Name of individual signing MIKE TUCKER
OBSTETRICS & GYNECOLOGY ASSOCIATES OF NORTHWEST ALABAMA, P.C. 401(K) PROFIT SHARING PLAN 2021 630816549 2022-10-10 OBSTETRICS & GYNECOLOGY ASSOCIATES OF NORTHWEST ALABAMA, P.C. 90
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 2567185920
Plan sponsor’s address 2407 HELTON DRIVE, FLORENCE, AL, 35630

Signature of

Role Plan administrator
Date 2022-10-10
Name of individual signing MIKE TUCKER
OBSTETRICS & GYNECOLOGY ASSOCIATES OF NORTHWEST ALABAMA, P.C. 401(K) PROFIT SHARING PLAN 2020 630816549 2021-10-13 OBSTETRICS & GYNECOLOGY ASSOCIATES OF NORTHWEST ALABAMA, P.C. 87
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 2567185957
Plan sponsor’s address 2407 HELTON DRIVE, FLORENCE, AL, 35630
OBSTETRICS & GYNECOLOGY ASSOCIATES OF NORTHWEST ALABAMA, P.C. 401(K) PROFIT SHARING PLAN 2019 630816549 2020-10-12 OBSTETRICS & GYNECOLOGY ASSOCIATES OF NORTHWEST ALABAMA, P.C. 81
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 2567185922
Plan sponsor’s address 2407 HELTON DRIVE, FLORENCE, AL, 35630
OBSTETRICS & GYNECOLOGY ASSOCIATES OF NORTHWEST ALABAMA, P.C. 401(K) PROFIT SHARING PLAN 2018 630816549 2019-07-30 OBSTETRICS & GYNECOLOGY ASSOCIATES OF NORTHWEST ALABAMA, P.C. 75
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 2567185922
Plan sponsor’s address 2407 HELTON DRIVE, FLORENCE, AL, 35630

Signature of

Role Plan administrator
Date 2019-07-30
Name of individual signing RITA KIRCHLER
OBSTETRICS & GYNECOLOGY ASSOCIATES OF NORTHWEST ALABAMA, P.C. 401(K) PROFIT SHARING PLAN 2017 630816549 2018-07-31 OBSTETRICS & GYNECOLOGY ASSOCIATES OF NORTHWEST ALABAMA, P.C. 73
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 2567185922
Plan sponsor’s address 2407 HELTON DRIVE, FLORENCE, AL, 35630
OBSTETRICS & GYNECOLOGY ASSOCIATES OF NORTHWEST ALABAMA, P.C. 401(K) PROFIT SHARING PLAN 2016 630816549 2017-10-06 OBSTETRICS & GYNECOLOGY ASSOCIATES OF NORTHWEST ALABAMA, P.C. 73
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 2567185922
Plan sponsor’s address 2407 HELTON DRIVE, FLORENCE, AL, 35630

Signature of

Role Plan administrator
Date 2017-10-06
Name of individual signing KATHY COMPTON
OBSTETRICS & GYNECOLOGY ASSOCIATES OF NORTHWEST ALABAMA, P.C. 401(K) PROFIT SHARING PLAN 2015 630816549 2016-07-29 OBSTETRICS & GYNECOLOGY ASSOCIATES OF NORTHWEST ALABAMA, P.C. 70
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 2567185922
Plan sponsor’s address 2407 HELTON DRIVE, FLORENCE, AL, 35630

Signature of

Role Plan administrator
Date 2016-07-29
Name of individual signing KATHY COMPTON
OBSTETRICS & GYNECOLOGY ASSOCIATES OF NORTHWEST ALABAMA, P.C. 401(K) PROFIT SHARING PLAN 2014 630816549 2015-07-21 OBSTETRICS & GYNECOLOGY ASSOCIATES OF NORTHWEST ALABAMA, P.C. 72
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 2567185922
Plan sponsor’s address 2407 HELTON DRIVE, FLORENCE, AL, 35630

Signature of

Role Plan administrator
Date 2015-07-21
Name of individual signing KATHY COMPTON
OBSTETRICS & GYNECOLOGY ASSOCIATES OF NORTHWEST ALABAMA, P.C. 401(K) PROFIT SHARING PLAN 2013 630816549 2014-07-30 OBSTETRICS & GYNECOLOGY ASSOCIATES OF NORTHWEST ALABAMA, P.C. 68
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1987-01-01
Business code 621111
Sponsor’s telephone number 2567185922
Plan sponsor’s address 2407 HELTON DRIVE, FLORENCE, AL, 35630

Plan administrator’s name and address

Administrator’s EIN 630816549
Plan administrator’s name OBSTETRICS & GYNECOLOGY ASSOCIATES OF NORTHWEST ALABAMA, P.C.
Plan administrator’s address 2407 HELTON DRIVE, FLORENCE, AL, 35630
Administrator’s telephone number 2567185922

Signature of

Role Plan administrator
Date 2014-07-30
Name of individual signing KATHY COMPTON

Agent

Name Role
CHAPPELL, SEABORN M DR Agent

Incorporator

Name Role Address
PITTS, CONRAD C Incorporator 401 EAST TUSCALOOSA STFLORENCE, AL 35630

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State