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Eastern Shore Care Services, P.C.

Details

Name: Eastern Shore Care Services, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 31 Mar 1997 (28 years ago)
Entity Number: 000-187-012
Register Number: 000187012
Historical Names: Eastern Shore Plastic & Reconstructive Surgery, P.C.
Eastern Shore Plastic Surgery, P.C.
Eastern Shore Aesthetic Services, P.C.
County: Baldwin
Place of Formation: Jefferson County
Principal Mailing Address: POST OFFICE BOX 509MONTROSE, AL 36559
Principal Mailing Address ZIP Code: 36559
Registered Office Street Address: 109 AUGUSTA CTFAIRHOPE, AL 36532
Registered Office Street Address ZIP Code: 36532
Authorized Capital: $1,000

Activities TO ENGAGE IN EVERY ASPECT OF THE PRACTICE OF MEDCINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1699068783 2011-05-23 2019-07-17 2935 THOUSAND OAKS DR STE 294, SAN ANTONIO, TX, 782473563, US 411 N SECTION ST, FAIRHOPE, AL, 365322649, US

Contacts
Phone +1 210-494-1100
Fax 2519292500
Phone +1 251-928-9090
Fax 2519900520

Authorized person
Name DR. WILLIAM R STAGGERS
Role PRESIDENT OWNER
Phone 2519297850

Taxonomy
Taxonomy Code 261QA1903X - Ambulatory Surgical Clinic/Center
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EASTERN SHORE PLASTIC SURGERY, PC PROFIT SHARING 2013 721361759 2014-12-15 EASTERN SHORE PLASTIC SURGERY, P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621111
Sponsor’s telephone number 2519297850
Plan sponsor’s address 7541 CIPRIANO COURT, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2014-12-15
Name of individual signing WILLIAM STAGGERS
EASTERN SHORE PLASTIC SURGERY, PC PROFIT SHARING 2013 721361759 2014-03-11 EASTERN SHORE PLASTIC SURGERY, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621111
Sponsor’s telephone number 2519297850
Plan sponsor’s address 7541 CIPRIANO COURT, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2014-03-11
Name of individual signing WILLIAM STAGGERS
Role Employer/plan sponsor
Date 2014-03-11
Name of individual signing WILLIAM STAGGERS
EASTERN SHORE PLASTIC SURGERY, PC PROFIT SHARING 2012 721361759 2013-04-22 EASTERN SHORE PLASTIC SURGERY, P.C. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621111
Sponsor’s telephone number 2519297850
Plan sponsor’s address 7541 CIPRIANO COURT, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2013-04-22
Name of individual signing WILLIAM STAGGERS
Role Employer/plan sponsor
Date 2013-04-19
Name of individual signing WILLIAM STAGGERS
EASTERN SHORE PLASTIC SURGERY, PC PROFIT SHARING 2011 721361759 2012-03-29 EASTERN SHORE PLASTIC SURGERY, P.C. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621111
Sponsor’s telephone number 2519297850
Plan sponsor’s address 7541 CIPRIANO COURT, FAIRHOPE, AL, 36532

Plan administrator’s name and address
Administrator’s EIN 721361759
Plan administrator’s name EASTERN SHORE PLASTIC SURGERY, P.C.
Plan administrator’s address 7541 CIPRIANO COURT, FAIRHOPE, AL, 36532
Administrator’s telephone number 2519297850

Signature of
Role Plan administrator
Date 2012-03-29
Name of individual signing WILLIAM STAGGERS
Role Employer/plan sponsor
Date 2012-03-29
Name of individual signing WILLIAM STAGGERS
EASTERN SHORE PLASTIC SURGERY, PC PROFIT SHARING 2010 721361759 2011-05-10 EASTERN SHORE PLASTIC SURGERY, P.C. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621111
Sponsor’s telephone number 2519297850
Plan sponsor’s address 7541 CIPRIANO COURT, FAIRHOPE, AL, 36532

Plan administrator’s name and address
Administrator’s EIN 721361759
Plan administrator’s name EASTERN SHORE PLASTIC SURGERY, P.C.
Plan administrator’s address 7541 CIPRIANO COURT, FAIRHOPE, AL, 36532
Administrator’s telephone number 2519297850

Signature of
Role Plan administrator
Date 2011-05-10
Name of individual signing WILLIAM STAGGERS
EASTERN SHORE PLASTIC SURGERY, PC PROFIT SHARING 2009 721361759 2010-07-13 EASTERN SHORE PLASTIC SURGERY, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1998-01-01
Business code 621111
Sponsor’s telephone number 2519297850
Plan sponsor’s address 7541 CIPRIANO COURT, FAIRHOPE, AL, 36532

Plan administrator’s name and address
Administrator’s EIN 721361759
Plan administrator’s name EASTERN SHORE PLASTIC SURGERY, P.C.
Plan administrator’s address 7541 CIPRIANO COURT, FAIRHOPE, AL, 36532
Administrator’s telephone number 2519297850

Signature of
Role Plan administrator
Date 2010-07-13
Name of individual signing WILLIAM STAGGERS

Agent

Name Role
STAGGERS, WILLIAM R Agent

Incorporator

Name Role
STAGGERS, WILLIAM R MD Incorporator

Events

Event Date Event Type Old Value New Value
2014-12-19 Name Change Eastern Shore Aesthetic Services, P.C. Eastern Shore Care Services, P.C.
2014-08-04 Name Change Eastern Shore Plastic Surgery, P.C. Eastern Shore Aesthetic Services, P.C.
2000-10-16 Name Change Eastern Shore Plastic & Reconstructive Surgery, P.C. Eastern Shore Plastic Surgery, P.C.

Related by officers

STAGGERS, WILLIAM R

Bon Aventure Too, L.L.C. Montrose of Scotland, L.L.C.

Related by address

No related companies by address

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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