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Surgical Associates of South Alabama, P.C.

Details

Name: Surgical Associates of South Alabama, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Dissolved
Date of registration: 16 Oct 1992 (32 years ago)
Date of dissolution: 19 Jan 2023
Entity Number: 000-152-758
Register Number: 000152758
County: Escambia
Place of Formation: Escambia County
Principal Address: BREWTON, AL
Registered Office Street Address: 103 ELLIOTT STBREWTON, AL 36426
Registered Office Street Address ZIP Code: 36426
Authorized Capital: $5,000

Activities PRACTICE MEDICINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1982660536 2006-04-23 2010-02-02 PO BOX 384, BREWTON, AL, 364270384, US 103 ELLIOTT ST, BREWTON, AL, 364261336, US

Contacts
Phone +1 251-867-8007
Fax 2518679643
Phone +1 251-867-8001

Authorized person
Name MRS. IRENE F BONDURANT
Role OFFICE MANAGER
Phone 2518678001

Taxonomy
Taxonomy Code 208600000X - Surgery Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SURGICAL ASSOCIATES OF SOUTH ALABAMA, P.C. PROFIT SHARING PLAN AND TRUST 2023 631076880 2024-07-09 SURGICAL ASSOCIATES OF SOUTH ALABAMA, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2518678001
Plan sponsor’s address PO BOX 384, BREWTON, AL, 36427

Signature of
Role Plan administrator
Date 2024-07-09
Name of individual signing THOMAS BOSHELL
SURGICAL ASSOCIATES OF SOUTH ALABAMA, P.C. PROFIT SHARING PLAN AND TRUST 2022 631076880 2023-10-03 SURGICAL ASSOCIATES OF SOUTH ALABAMA, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2518678001
Plan sponsor’s address P O BOX 384, BREWTON, AL, 36427

Signature of
Role Plan administrator
Date 2023-10-03
Name of individual signing THOMAS BOSHELL
SURGICAL ASSOCIATES OF SOUTH ALABAMA, P.C. PROFIT SHARING PLAN AND TRUST 2021 631076880 2022-07-19 SURGICAL ASSOCIATES OF SOUTH ALABAMA, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2518678001
Plan sponsor’s address P O BOX 384, BREWTON, AL, 36427

Signature of
Role Plan administrator
Date 2022-07-19
Name of individual signing THOMAS BOSHELL
SURGICAL ASSOCIATES OF SOUTH ALABAMA, P.C. PROFIT SHARING PLAN AND TRUST 2020 631076880 2021-07-19 SURGICAL ASSOCIATES OF SOUTH ALABAMA, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2518678001
Plan sponsor’s address 1123 BELLEVILLE AVENUE, PO BOX 384, BREWTON, AL, 364270384

Signature of
Role Plan administrator
Date 2021-07-19
Name of individual signing THOMAS BOSHELL
SURGICAL ASSOCIATES OF SOUTH ALABAMA, PC PROFIT SHARING PLAN AND TRUST 2018 631076880 2019-07-30 SURGICAL ASSOCIATES OF SOUTH ALABAMA, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2518678001
Plan sponsor’s address PO BOX 384, BREWTON, AL, 364270384

Signature of
Role Plan administrator
Date 2019-07-30
Name of individual signing THOMAS BOSHELL
Role Employer/plan sponsor
Date 2019-07-30
Name of individual signing THOMAS BOSHELL
SURGICAL ASSOCIATES OF SOUTH ALABAMA, PC PROFIT SHARING PLAN & TRUST 2017 631076880 2018-10-12 SURGICAL ASSOCIATES OF SOUTH ALABAMA, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2518678001
Plan sponsor’s address PO BOX 384, BREWTON, AL, 364270384

Signature of
Role Plan administrator
Date 2018-10-12
Name of individual signing THOMAS BOSHELL
Role Employer/plan sponsor
Date 2018-10-12
Name of individual signing THOMAS BOSHELL
SURGICAL ASSOCIATES OF SOUTH ALABAMA, PC PROFIT SHARING PLAN & TRUST 2016 631076880 2017-10-12 SURGICAL ASSOCIATES OF SOUTH ALABAMA, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2518678001
Plan sponsor’s address PO BOX 384, BREWTON, AL, 364270384

Signature of
Role Plan administrator
Date 2017-10-12
Name of individual signing THOMAS BOSHELL
SURGICAL ASSOCIATES OF SOUTH ALABAMA, PC PROFIT SHARING PLAN & TRUST 2015 631076880 2016-10-14 SURGICAL ASSOCIATES OF SOUTH ALABAMA, P.C. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2518678001
Plan sponsor’s address PO BOX 384, BREWTON, AL, 364270384

Signature of
Role Plan administrator
Date 2016-10-14
Name of individual signing THOMAS BOSHELL
Role Employer/plan sponsor
Date 2016-10-14
Name of individual signing THOMAS BOSHELL
SURGICAL ASSOCIATES OF SOUTH ALABAMA, PC PROFIT SHARING PLAN & TRUST 2014 631098821 2015-10-13 SURGICAL ASSOCIATES OF SOUTH ALABAMA, P.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2518678001
Plan sponsor’s address P. O. BOX 384, BREWTON, AL, 36427

Signature of
Role Plan administrator
Date 2015-10-13
Name of individual signing THOMAS BOSHELL
Role Employer/plan sponsor
Date 2015-10-13
Name of individual signing THOMAS BOSHELL
SURGICAL ASSOCIATES OF SOUTH ALABAMA, PC PROFIT SHARING PLAN & TRUST 2013 631098821 2014-02-12 SURGICAL ASSOCIATES OF SOUTH ALABAMA, P.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2518678001
Plan sponsor’s address P O BOX 384, BREWTON, AL, 36427

Plan administrator’s name and address
Administrator’s EIN 631098821
Plan administrator’s name SURGICAL ASSOCIATES OF SOUTH ALABAMA, P.C.
Plan administrator’s address P O BOX 384, BREWTON, AL, 36427
Administrator’s telephone number 2518678001

Signature of
Role Plan administrator
Date 2014-02-12
Name of individual signing THOMAS E. BOSHELL

Agent

Name Role
SALOOM, SALEM G MD Agent

Incorporator

Name Role
SMITH, ROBERT R Incorporator
SALOOM, SALEM G Incorporator

Related by officers

SMITH, ROBERT R

Robert R. Smith, M.D., P.A. Alabama City Post No. 46, American Legion.

SALOOM, SALEM G

Saloom Properties, LLC

Related by address

BREWTON, AL

Bank of Brewton Brewton Aviation Service, Inc. Brewton Flower Shop, Inc. Brewton Professional Building, Inc. Brewton Weaving Co., Incorporated Craver's Brown Service Home, Inc. Escambia County Cooperative Escambia Insurance Agency Farmers Exchange of Brewton, Inc. Fountain-Lowrey Enterprises, Inc.

103 ELLIOTT STBREWTON, AL 36426

Salem Saloom, M.D., P.C.

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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