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Neuro-Eval, P.C.

Details

Name: Neuro-Eval, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 01 Sep 1994 (30 years ago)
Entity Number: 000-166-418
Register Number: 000166418
County: Houston
Place of Formation: Houston County
Principal Address: DOTHAN, AL
Registered Office Street Address: 1118 ROSS CLARK CIRCLEDOTHAN, AL 36301
Registered Office Street Address ZIP Code: 36301
Authorized Capital: $1,000
Paid Share Capital: ----

Activities MEDICAL SPECIALTY OF NEUROLOGY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1922030360 2006-07-07 2020-08-22 105 N PONTIAC AVE, SUITE 1, DOTHAN, AL, 363033959, US 105 N PONTIAC AVE, SUITE 1, DOTHAN, AL, 363033959, US

Contacts
Phone +1 334-677-6425
Fax 3346776921

Authorized person
Name MRS. BRENDA BENTON
Role OFFICE MANAGER
Phone 3346776425

Taxonomy
Taxonomy Code 174400000X - Specialist
License Number 10583
State AL
Is Primary Yes

Other Provider Identifiers
Issuer BCBS AL
Number 51089293
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NEURO-EVAL, P.C. PROFIT SHARING PLAN 2023 631126278 2024-05-06 NEURO-EVAL, P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 3346712887
Plan sponsor’s address 105 NORTH PONTIAC AVENUE, SUITE 1, DOTHAN, AL, 36303
NEURO-EVAL, P.C. PROFIT SHARING PLAN 2022 631126278 2023-07-18 NEURO-EVAL, P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 3346712887
Plan sponsor’s address 105 NORTH PONTIAC AVENUE, SUITE 1, DOTHAN, AL, 36303
NEURO-EVAL, P.C. PROFIT SHARING PLAN 2021 631126278 2022-04-11 NEURO-EVAL, P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 3346712887
Plan sponsor’s address 105 NORTH PONTIAC AVENUE, SUITE 1, DOTHAN, AL, 36303
NEURO-EVAL, P.C. PROFIT SHARING PLAN 2020 631126278 2021-04-29 NEURO-EVAL, P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 3346712887
Plan sponsor’s address 105 NORTH PONTIAC AVENUE, SUITE 1, DOTHAN, AL, 36303
NEURO-EVAL, P.C. PROFIT SHARING PLAN 2019 631126278 2020-09-21 NEURO-EVAL, P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 3346712887
Plan sponsor’s address 105 NORTH PONTIAC AVENUE, SUITE 1, DOTHAN, AL, 36303
NEURO-EVAL, P.C. PROFIT SHARING PLAN 2018 631126278 2020-08-17 NEURO-EVAL, P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 3346712887
Plan sponsor’s address 105 NORTH PONTIAC AVENUE, SUITE 1, DOTHAN, AL, 36303
NEURO-EVAL, P.C. PROFIT SHARING PLAN 2018 631126278 2019-10-15 NEURO-EVAL, P.C. 5
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 3346712887
Plan sponsor’s address 105 NORTH PONTIAC AVENUE SUITE 1, DOTHAN, AL, 36303

Plan administrator’s name and address
Administrator’s EIN 631126278
Plan administrator’s name NEURO-EVAL, P.C.
Plan administrator’s address 105 NORTH PONTIAC AVENUE SUITE 1, DOTHAN, AL, 36303
Administrator’s telephone number 3346712887
NEURO-EVAL, P.C. PROFIT SHARING PLAN 2016 631126278 2017-10-17 NEURO-EVAL, P.C. 7
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 3346712887
Plan sponsor’s address 105 NORTH PONTIAC AVENUE SUITE 1, DOTHAN, AL, 36303

Plan administrator’s name and address
Administrator’s EIN 631126278
Plan administrator’s name NEURO-EVAL, P.C.
Plan administrator’s address 105 NORTH PONTIAC AVENUE SUITE 1, DOTHAN, AL, 36303
Administrator’s telephone number 3346712887
NEURO-EVAL, P.C. PROFIT SHARING PLAN 2015 631126278 2016-10-15 NEURO-EVAL, P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 3346712887
Plan sponsor’s address 105 NORTH PONTIAC AVENUE SUITE 1, DOTHAN, AL, 36303

Plan administrator’s name and address
Administrator’s EIN 631126278
Plan administrator’s name NEURO-EVAL, P.C.
Plan administrator’s address 105 NORTH PONTIAC AVENUE SUITE 1, DOTHAN, AL, 36303
Administrator’s telephone number 3346712887
NEURO-EVAL, P.C. PROFIT SHARING PLAN 2014 631126278 2015-10-15 NEURO-EVAL, P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1992-01-01
Business code 621111
Sponsor’s telephone number 3346712887
Plan sponsor’s address 105 NORTH PONTIAC AVENUE SUITE 1, DOTHAN, AL, 36303

Plan administrator’s name and address
Administrator’s EIN 631126278
Plan administrator’s name NEURO-EVAL, P.C.
Plan administrator’s address 105 NORTH PONTIAC AVENUE SUITE 1, DOTHAN, AL, 36303
Administrator’s telephone number 3346712887

Signature of
Role Plan administrator
Date 2015-10-15
Name of individual signing PAULA L. SHELLEY

Agent

Name Role
ALLEN, ROBERT F Agent

Incorporator

Name Role
ALLEN, ROBERT F Incorporator

Related by officers

ALLEN, ROBERT F

Robert F. Allen, M.D., P.C.

Related by address

DOTHAN, AL

A & M Electrical Construction Co., Inc. Acme Auction Company of Dothan, Inc. Acme Lease-A-Car, Inc. Acme Roofing and Sheet Metal Company, Inc. Adams Foods, Inc. Adams Trading Center Alabama Electric Company, Inc. of Dothan Art & Craft Hut, Inc. Southeastern Cabinet Co., Inc. Auto Electric Company of Alabama, Incorporated

1118 ROSS CLARK CIRCLEDOTHAN, AL 36301

Urological Associates of Dothan, P.A.

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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