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Eastern Shore Heart Center, Inc.

Details

Name: Eastern Shore Heart Center, Inc.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 09 Mar 1999 (26 years ago)
Entity Number: 000-201-437
Register Number: 000201437
Historical Names: Eastern Shore Cardiology, P.C.
County: Mobile
Place of Formation: Mobile County
Principal Address: MOBILE, AL
Registered Office Street Address: 4210 WILINSON WAYMOBILE, AL 36608
Registered Office Street Address ZIP Code: 36608
Authorized Capital: $3,000

Activities PRACTICE OF MEDICINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1740394105 2006-08-19 2008-03-17 19725 SOUTH GREENO ROAD, FAIRHOPE, AL, 365323843, US 19725 SOUTH GREENO ROAD, FAIRHOPE, AL, 365323843, US

Contacts
Phone +1 251-990-1930
Fax 2519901931

Authorized person
Name DR. CRAIG R PETERSON
Role PHYSICIAN /PRESIDENT
Phone 2519901930

Taxonomy
Taxonomy Code 174400000X - Specialist
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EASTERN SHORE HEART CENTER CASH BALANCE PLAN 2023 631220236 2024-03-20 EASTERN SHORE HEART CENTER 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2519901930
Plan sponsor’s address 19725 SOUTH GREENO ROAD, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2024-03-20
Name of individual signing CRAIG PETERSON
Role Employer/plan sponsor
Date 2024-03-20
Name of individual signing CRAIG PETERSON
EASTERN SHORE HEART CENTER CASH BALANCE PLAN 2023 631220236 2024-05-29 EASTERN SHORE HEART CENTER 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2519901930
Plan sponsor’s address 19725 SOUTH GREENO ROAD, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2024-05-29
Name of individual signing CRAIG PETERSON
Role Employer/plan sponsor
Date 2024-05-29
Name of individual signing CRAIG PETERSON
EASTERN SHORE HEART CENTER 401(K) PLAN 2023 631220236 2024-06-17 EASTERN SHORE HEART CENTER 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 2519901930
Plan sponsor’s address 19725 SOUTH GREENO ROAD, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2024-06-17
Name of individual signing CRAIG PETERSON
EASTERN SHORE HEART CENTER CASH BALANCE PLAN 2022 631220236 2023-09-21 EASTERN SHORE HEART CENTER 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2519901930
Plan sponsor’s address 19725 SOUTH GREENO ROAD, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2023-09-21
Name of individual signing CRAIG PETERSON
Role Employer/plan sponsor
Date 2023-09-21
Name of individual signing CRAIG PETERSON
EASTERN SHORE HEART CENTER 401(K) PLAN 2022 631220236 2023-06-16 EASTERN SHORE HEART CENTER 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 2519901930
Plan sponsor’s address 19725 SOUTH GREENO ROAD, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2023-06-16
Name of individual signing CRAIG PETERSON
EASTERN SHORE HEART CENTER 401(K) PLAN 2021 631220236 2022-06-17 EASTERN SHORE HEART CENTER 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 2519901930
Plan sponsor’s address 19725 SOUTH GREENO ROAD, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2022-06-17
Name of individual signing CRAIG PETERSON
EASTERN SHORE HEART CENTER CASH BALANCE PLAN 2021 631220236 2022-10-07 EASTERN SHORE HEART CENTER 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2519901930
Plan sponsor’s address 19725 SOUTH GREENO ROAD, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2022-10-07
Name of individual signing CRAIG PETERSON
Role Employer/plan sponsor
Date 2022-10-07
Name of individual signing CRAIG PETERSON
EASTERN SHORE HEART CENTER 401(K) PLAN 2020 631220236 2021-06-23 EASTERN SHORE HEART CENTER 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-01-01
Business code 621111
Sponsor’s telephone number 2519901930
Plan sponsor’s address 19725 SOUTH GREENO ROAD, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2021-06-23
Name of individual signing CRAIG PETERSON
EASTERN SHORE HEART CENTER CASH BALANCE PLAN 2020 631220236 2021-04-23 EASTERN SHORE HEART CENTER 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2519901930
Plan sponsor’s address 19725 SOUTH GREENO ROAD, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2021-04-23
Name of individual signing PETERSON CRAIG
Role Employer/plan sponsor
Date 2021-04-23
Name of individual signing PETERSON CRAIG
EASTERN SHORE HEART CENTER CASH BALANCE PLAN 2019 631220236 2020-08-27 EASTERN SHORE HEART CENTER 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2519901930
Plan sponsor’s address 19725 SOUTH GREENO ROAD, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2020-08-27
Name of individual signing CRAIG PETERSON
Role Employer/plan sponsor
Date 2020-08-27
Name of individual signing CRAIG PETERSON

Agent

Name Role
PETERSON, CRAIG R Agent

Incorporator

Name Role Address
KIRKPATRICK, R MARK Incorporator 2610-B DAUPHIN ST SUITE 101MOBILE, AL 36606

Events

Event Date Event Type Old Value New Value
2000-03-16 Name Change Eastern Shore Cardiology, P.C. Eastern Shore Heart Center, Inc.

Related by officers

PETERSON, CRAIG R

Eastern Shore Medical Plaza, L.L.C.

KIRKPATRICK, R MARK

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Related by address

MOBILE, AL

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Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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