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Mountain Lake Orthopedics, P.C.

Details

Name: Mountain Lake Orthopedics, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Dissolved
Date of registration: 30 Dec 1993 (31 years ago)
Date of dissolution: 10 Apr 2009
Entity Number: 000-161-059
Register Number: 000161059
County: Marshall
Place of Formation: Marshall County
Principal Address: GUNTERSVILLE, AL
Registered Office Street Address: 38 ROWE DRIVEGUNTERSVILLE, AL 35976
Registered Office Street Address ZIP Code: 35976
Authorized Capital: $1,000
Paid Share Capital: $1,000

Activities PRACTICE THE PROFESSION OF MEDICINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1366522856 2006-10-17 2020-08-22 1912 CHEROKEE AVE SW, SUITE 3200, CULLMAN, AL, 350555595, US 1912 CHEROKEE AVE SW, SUITE 3200, CULLMAN, AL, 350555595, US

Contacts
Phone +1 256-736-5505
Fax 2567365551

Authorized person
Name JOHN EUGENE SONGER
Role PRESIDENT
Phone 2567365505

Taxonomy
Taxonomy Code 207X00000X - Orthopaedic Surgery Physician
License Number 13890
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MOUNTAIN LAKE ORTHOPEDICS, P.C. 401(K) PROFIT SHARING PLAN 2013 631107700 2014-07-23 MOUNTAIN LAKE ORTHOPEDICS, P.C. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 2567365505
Plan sponsor’s address 1800 ALABAMA HIGHWAY 157, SUITE 100, CULLMAN, AL, 35058

Signature of
Role Plan administrator
Date 2014-07-23
Name of individual signing JOHN SONGER
Role Employer/plan sponsor
Date 2014-07-23
Name of individual signing JOHN SONGER
MOUNTAIN LAKE ORTHOPEDICS, P.C. 401(K) PROFIT SHARING PLAN 2012 631107700 2013-07-16 MOUNTAIN LAKE ORTHOPEDICS, P.C. 1
Three-digit plan number (PN) 001
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 2567365505
Plan sponsor’s mailing address 1800 ALABAMA HIGHWAY 157, SUITE 100, CULLMAN, AL, 35058
Plan sponsor’s address 1800 ALABAMA HIGHWAY 157, SUITE 100, CULLMAN, AL, 35058

Number of participants as of the end of the plan year
Active participants 1
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 1
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2013-07-15
Name of individual signing JOHN SONGER
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN LAKE ORTHOPEDICS, P.C. 401(K) PROFIT SHARING PLAN 2011 631107700 2012-07-30 MOUNTAIN LAKE ORTHOPEDICS, P.C. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 2567365505
Plan sponsor’s mailing address 1800 ALABAMA HIGHWAY 157, SUITE 100, CULLMAN, AL, 35058
Plan sponsor’s address 1800 ALABAMA HIGHWAY 157, SUITE 100, CULLMAN, AL, 35058

Plan administrator’s name and address
Administrator’s EIN 631107700
Plan administrator’s name MOUNTAIN LAKE ORTHOPEDICS, P.C.
Plan administrator’s address 1800 ALABAMA HIGHWAY 157, SUITE 100, CULLMAN, AL, 35058
Administrator’s telephone number 2567365505

Number of participants as of the end of the plan year
Active participants 1
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 1
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2012-07-30
Name of individual signing JOHN SONGER
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN LAKE ORTHOPEDICS, P.C. 401(K) PROFIT SHARING PLAN 2010 631107700 2011-07-28 MOUNTAIN LAKE ORTHOPEDICS, P.C. 1
Three-digit plan number (PN) 001
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 2567365505
Plan sponsor’s mailing address 1800 ALABAMA HIGHWAY 157, SUITE 100, CULLMAN, AL, 35058
Plan sponsor’s address 1800 ALABAMA HIGHWAY 157, SUITE 100, CULLMAN, AL, 35058

Plan administrator’s name and address
Administrator’s EIN 631107700
Plan administrator’s name MOUNTAIN LAKE ORTHOPEDICS, P.C.
Plan administrator’s address 1800 ALABAMA HIGHWAY 157, SUITE 100, CULLMAN, AL, 35058
Administrator’s telephone number 2567365505

Number of participants as of the end of the plan year
Active participants 1
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 1
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Employer/plan sponsor
Date 2011-07-28
Name of individual signing JOHN SONGER
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN LAKE ORTHOPEDICS, P.C. 401(K) PROFIT SHARING PLAN 2010 631107700 2011-07-28 MOUNTAIN LAKE ORTHOPEDICS, P.C. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 2567365505
Plan sponsor’s mailing address 1800 ALABAMA HIGHWAY 157, SUITE 100, CULLMAN, AL, 35058
Plan sponsor’s address 1800 ALABAMA HIGHWAY 157, SUITE 100, CULLMAN, AL, 35058

Plan administrator’s name and address
Administrator’s EIN 631107700
Plan administrator’s name MOUNTAIN LAKE ORTHOPEDICS, P.C.
Plan administrator’s address 1800 ALABAMA HIGHWAY 157, SUITE 100, CULLMAN, AL, 35058
Administrator’s telephone number 2567365505

Number of participants as of the end of the plan year
Active participants 1
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 1
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2011-07-28
Name of individual signing JOHN SONGER
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN LAKE ORTHOPEDICS, P.C. 401(K) PROFIT SHARING PLAN 2009 631107700 2010-07-28 MOUNTAIN LAKE ORTHOPEDICS, P.C. 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1989-01-01
Business code 621111
Sponsor’s telephone number 2567365505
Plan sponsor’s mailing address 1800 ALABAMA HIGHWAY 157, SUITE 100, CULLMAN, AL, 35058
Plan sponsor’s address 1800 ALABAMA HIGHWAY 157, SUITE 100, CULLMAN, AL, 35058

Plan administrator’s name and address
Administrator’s EIN 631107700
Plan administrator’s name MOUNTAIN LAKE ORTHOPEDICS, P.C.
Plan administrator’s address 1800 ALABAMA HIGHWAY 157, SUITE 100, CULLMAN, AL, 35058
Administrator’s telephone number 2567365505

Number of participants as of the end of the plan year
Active participants 1
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 1
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 0

Signature of
Role Plan administrator
Date 2010-07-28
Name of individual signing JOHN SONGER
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
SONGER, JOHN E Agent

Incorporator

Name Role
SONGER, JOHN E Incorporator

Related by officers

SONGER, JOHN E

DCB, LLC

Related by address

GUNTERSVILLE, AL

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Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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