| Name: | Tuscaloosa Nephrology Associates, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 06 Jan 1995 (30 years ago) |
| Entity Number: | 000-168-703 |
| Register Number: | 000168703 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Principal Address: | TUSCLOOSA, AL |
| Registered Office Street Address: | 1850 MCFARLAND BLVD NTUSCALOOSA, AL 35406 |
| Registered Office Street Address ZIP Code: | 35406 |
| Authorized Capital: | $15,000 |
| Paid Share Capital: | ---- |
Activities
PRACTICE OF MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215020318 | 2006-10-02 | 2015-05-28 | 1850 MCFARLAND BLVD N, TUSCALOOSA, AL, 354062138, US | 1850 MCFARLAND BLVD N, TUSCALOOSA, AL, 354062138, US | |||||||||||||||||||||||||||
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| Phone | +1 205-556-5541 |
| Fax | 2055547937 |
Authorized person
| Name | DR. DIRK BERRY |
| Role | PRESIDENT MD |
| Phone | 2055565541 |
Taxonomy
| Taxonomy Code | 207RN0300X - Nephrology Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE RAILROAD |
| Number | CN3399 |
| State | AL |
| Issuer | MEDICAID |
| Number | 528903280 |
| State | AL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TUSCALOOSA NEPHROLOGY ASSOCIATES, P.C. 401(K) PROFIT SHARING PLAN | 2009 | 631134539 | 2010-09-16 | TUSCALOOSA NEPHROLOGY ASSOCIATES, P.C. | 10 | |||||||||||||||||||||||||||||
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| Administrator’s EIN | 631134539 |
| Plan administrator’s name | TUSCALOOSA NEPHROLOGY ASSOCIATES, P.C. |
| Plan administrator’s address | 1649 MCFARLAND BLVD. NORTH, SUITE 203, TUSCALOOSA, AL, 35406 |
| Administrator’s telephone number | 2055565541 |
Signature of
| Role | Plan administrator |
| Date | 2010-09-15 |
| Name of individual signing | RICHARD W. GURICH, M.D. |
| Name | Role | Address |
|---|---|---|
| BERRY, DIRK L | Agent | 1649 MCFARLAND BLVD STE 203TUSCALOOSA, AL 35046 |
| Name | Role | Address |
|---|---|---|
| ASKEW, JAMES D | Incorporator | No data |
| BERRY, DIRK L | Incorporator | 1649 MCFARLAND BLVD STE 203TUSCALOOSA, AL 35046 |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
