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Selma Heart Institute, P.C.

Details

Name: Selma Heart Institute, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 24 Jun 1999 (25 years ago)
Entity Number: 000-203-582
Register Number: 000203582
County: Dallas
Place of Formation: Dallas County
Principal Address: SELMA, AL
Registered Office Street Address: 410 CHURCH STSELMA, AL 36701
Registered Office Street Address ZIP Code: 36701
Authorized Capital: $100

Activities MEDICAL/HEALTHCARE SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1962561027 2006-12-06 2020-08-22 913 MEDICAL CENTER PKWY, SELMA, AL, 367016746, US 913 MEDICAL CENTER PKWY, SELMA, AL, 367016746, US

Contacts
Phone +1 334-872-2001
Fax 3348720580

Authorized person
Name DR. SEYDI V AKSUT
Role PRESIDENT
Phone 3348722001

Taxonomy
Taxonomy Code 207RC0000X - Cardiovascular Disease Physician
License Number 19165
State AL
Is Primary Yes

Other Provider Identifiers
Issuer BLUE CROSS, BLUE SHIELD
Number 51020866
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SELMA HEART INSTITUTE PROFIT SHARING PLAN 2017 631228459 2018-05-14 SELMA HEART INSTITUTE 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621498
Sponsor’s telephone number 3348722001
Plan sponsor’s address 913 MEDICAL CENTER PARKWAY, SELMA, AL, 36701
SELMA HEART INSTITUTE PROFIT SHARING PLAN 2016 631228459 2017-03-28 SELMA HEART INSTITUTE 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621498
Sponsor’s telephone number 3348722001
Plan sponsor’s address 913 MEDICAL CENTER PARKWAY, SELMA, AL, 36701
SELMA HEART INSTITUTE PROFIT SHARING PLAN 2015 631228459 2016-10-03 SELMA HEART INSTITUTE 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621498
Sponsor’s telephone number 3348722001
Plan sponsor’s address 913 MEDICAL CENTER PARKWAY, SELMA, AL, 36701
SELMA HEART INSTITUTE PROFIT SHARING PLAN 2014 631228459 2015-09-30 SELMA HEART INSTITUTE 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621498
Sponsor’s telephone number 3348722001
Plan sponsor’s address 913 MEDICAL CENTER PARKWAY, SELMA, AL, 36701

Signature of
Role Plan administrator
Date 2015-09-30
Name of individual signing SEYDI V. AKSUT, M.D.
SELMA HEART INSTITUTE PROFIT SHARING PLAN 2013 631228459 2014-06-30 SELMA HEART INSTITUTE 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621498
Sponsor’s telephone number 3348722001
Plan sponsor’s address 913 MEDICAL CENTER PARKWAY, SELMA, AL, 36701

Signature of
Role Plan administrator
Date 2014-06-30
Name of individual signing SEYDI V. AKSUT, M.D.
Role Employer/plan sponsor
Date 2014-06-30
Name of individual signing SEYDI V. AKSUT, M.D.
SELMA HEART INSTITUTE PROFIT SHARING PLAN 2012 631228459 2013-06-26 SELMA HEART INSTITUTE 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621498
Sponsor’s telephone number 3348722001
Plan sponsor’s address 913 MEDICAL CENTER PARKWAY, SELMA, AL, 36701

Signature of
Role Plan administrator
Date 2013-06-26
Name of individual signing SEYDI V. AKSUT, M.D.
Role Employer/plan sponsor
Date 2013-06-26
Name of individual signing SEYDI V. AKSUT, M.D.
SELMA HEART INSTITUTE PROFIT SHARING PLAN 2011 631228459 2012-07-23 SELMA HEART INSTITUTE 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621498
Sponsor’s telephone number 3348722001
Plan sponsor’s address 913 MEDICAL CENTER PARKWAY, SELMA, AL, 36701

Plan administrator’s name and address
Administrator’s EIN 631228459
Plan administrator’s name SELMA HEART INSTITUTE
Plan administrator’s address 913 MEDICAL CENTER PARKWAY, SELMA, AL, 36701
Administrator’s telephone number 3348722001

Signature of
Role Plan administrator
Date 2012-07-23
Name of individual signing C. PAT HILLIARD
SELMA HEART INSTITUTE PROFIT SHARING PLAN 2010 631228459 2012-07-17 SELMA HEART INSTITUTE 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621498
Sponsor’s telephone number 3348722001
Plan sponsor’s address 913 MEDICAL CENTER PARKWAY, SELMA, AL, 36701

Plan administrator’s name and address
Administrator’s EIN 631228459
Plan administrator’s name SELMA HEART INSTITUTE
Plan administrator’s address 913 MEDICAL CENTER PARKWAY, SELMA, AL, 36701
Administrator’s telephone number 3348722001

Signature of
Role Plan administrator
Date 2012-07-17
Name of individual signing C. PAT HILLIARD
SELMA HEART INSTITUTE PROFIT SHARING PLAN 2010 631228459 2011-10-12 SELMA HEART INSTITUTE 13
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621498
Sponsor’s telephone number 3348722001
Plan sponsor’s address 913 MEDICAL CENTER PARKWAY, SELMA, AL, 36701

Plan administrator’s name and address
Administrator’s EIN 631228459
Plan administrator’s name SELMA HEART INSTITUTE
Plan administrator’s address 913 MEDICAL CENTER PARKWAY, SELMA, AL, 36701
Administrator’s telephone number 3348722001

Signature of
Role Plan administrator
Date 2011-10-12
Name of individual signing C. PAT HILLIARD
SELMA HEART INSTITUTE PROFIT SHARING PLAN 2009 631228459 2010-10-09 SELMA HEART INSTITUTE 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Business code 621498
Sponsor’s telephone number 3348722001
Plan sponsor’s address 913 MEDICAL CENTER PARKWAY, SELMA, AL, 36701

Plan administrator’s name and address
Administrator’s EIN 631228459
Plan administrator’s name SELMA HEART INSTITUTE
Plan administrator’s address 913 MEDICAL CENTER PARKWAY, SELMA, AL, 36701
Administrator’s telephone number 3348722001

Signature of
Role Plan administrator
Date 2010-10-09
Name of individual signing C. PAT HILLIARD

Agent

Name Role
AKSUT, SEYDI V Agent

Incorporator

Name Role
AKSUT, SEYDI V Incorporator

Related by officers

No related officers

Related by address

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Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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