| Name: | Vincent E. Martin, M.D., P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 30 Aug 1999 (25 years ago) (Companies founded in August 1999) |
| Entity Number: | 000-204-803 |
| Register Number: | 000204803 |
| ZIP code: | 36330 (Companies in Coffee, 36330) |
| County: | Coffee |
| Place of Formation: | Coffee County |
| Principal Address: | ENTERPRISE, AL |
| Registered Office Street Address: | 400 NORTH EDWARDS STENTERPRISE, AL 36330 |
| Authorized Capital: | $1,000 |
| Paid Share Capital: | $1,000 |
Activities
GENERAL PRACTICE OF MEDICINE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831397017 | 2007-07-10 | 2011-10-14 | 702 N MAIN ST, OPP, AL, 364671626, US | 702 N MAIN ST, OPP, AL, 364671626, US | |||||||||||||||||||||||||||||||
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| Phone | +1 334-493-2342 |
| Fax | 3344932552 |
Authorized person
| Name | VINCENT E MARTIN JR. |
| Role | PRESIDENT |
| Phone | 3344932342 |
Taxonomy
| Taxonomy Code | 2085R0202X - Diagnostic Radiology Physician |
| License Number | 00015250 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529925140 |
| State | AL |
| Issuer | RAILROAD MEDICARE |
| Number | DD6290 |
| State | AL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| VINCENT E. MARTIN, M.D., P.C. 401(K) PROFIT SHARING PLAN | 2010 | 631233478 | 2011-08-30 | VINCENT E. MARTIN, M.D., P.C. | 3 | |||||||||||||||||||||||||||||
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| Administrator’s EIN | 631233478 |
| Plan administrator’s name | VINCENT E. MARTIN, M.D., P.C. |
| Plan administrator’s address | P. O. BOX 987, OPP, AL, 36467 |
| Administrator’s telephone number | 3344932342 |
Signature of
| Role | Plan administrator |
| Date | 2011-08-29 |
| Name of individual signing | VINCENT E. MARTIN |
| File | View Page |
| Three-digit plan number (PN) | 003 |
| Effective date of plan | 2003-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3344932342 |
| Plan sponsor’s address | P. O. BOX 987, OPP, AL, 36467 |
Plan administrator’s name and address
| Administrator’s EIN | 631233478 |
| Plan administrator’s name | VINCENT E. MARTIN, M.D., P.C. |
| Plan administrator’s address | P. O. BOX 987, OPP, AL, 36467 |
| Administrator’s telephone number | 3344932342 |
Signature of
| Role | Plan administrator |
| Date | 2010-08-16 |
| Name of individual signing | VINCENT E. MARTIN |
| Name | Role |
|---|---|
| MARTIN, VINCENT E | Agent |
| Name | Role |
|---|---|
| MARTIN, VINCENT E | Incorporator |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
