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Kopyta Internal Medicine, P.C.

Details

Name: Kopyta Internal Medicine, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 18 Jan 2001 (24 years ago) (Companies founded in January 2001)
Entity Number: 000-214-252
Register Number: 000214252
ZIP code: 35950 (Companies in Marshall, 35950)
County: Marshall
Place of Formation: Marshall County
Principal Address: ALBERTVILLE, AL
Registered Office Street Address: 312 SAND MOUNTAIN DR SEALBERTVILLE, AL 35950
Authorized Capital: $1,000
Paid Share Capital: $1,000

Activities PRACTICE OF MEDICINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1639476252 2011-02-16 2011-02-16 312 SAND MTN DR SE, ALBERTVILLE, AL, 359502330, US 312 SAND MTN DR SE, ALBERTVILLE, AL, 359502330, US

Contacts
Phone +1 256-891-4577
Fax 2568914919

Authorized person
Name DR. BARBARA ELZBIETA KUCEWICZ-KOPYTA
Role PRESIDENT
Phone 2568914577

Taxonomy
Taxonomy Code 261Q00000X - Clinic/Center
License Number 00021174
State AL
Is Primary Yes

Other Provider Identifiers
Issuer BCBS
Number 0515-01031
State AL
Issuer MEDICAID
Number 009951470
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KOPYTA INTERNAL MEDICINE, P.C. 401(K) PROFIT SHARING PLAN 2023 631266207 2024-07-28 KOPYTA INTERNAL MEDICINE, P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2568914577
Plan sponsor’s address 312 SAND MOUNTAIN DRIVE S.E., ALBERTVILLE, AL, 35950

Signature of
Role Plan administrator
Date 2024-07-28
Name of individual signing BARBARA KUCEWICZ-KOPYTA
KOPYTA INTERNAL MEDICINE, P.C. 401(K) PROFIT SHARING PLAN 2022 631266207 2023-05-01 KOPYTA INTERNAL MEDICINE, P.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2568914577
Plan sponsor’s address 312 SAND MOUNTAIN DRIVE S.E., ALBERTVILLE, AL, 35950

Signature of
Role Plan administrator
Date 2023-05-01
Name of individual signing BARBARA KUCEWICZ-KOPYTA
KOPYTA INTERNAL MEDICINE, P.C. 401(K) PROFIT SHARING PLAN 2021 631266207 2022-03-23 KOPYTA INTERNAL MEDICINE, P.C. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2568914577
Plan sponsor’s address 312 SAND MOUNTAIN DRIVE S.E., ALBERTVILLE, AL, 35950

Signature of
Role Plan administrator
Date 2022-03-23
Name of individual signing BARBARA KUCEWICZ-KOPYTA
KOPYTA INTERNAL MEDICINE, P.C. 401(K) PROFIT SHARING PLAN 2020 631266207 2021-07-20 KOPYTA INTERNAL MEDICINE, P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2568914577
Plan sponsor’s address 312 SAND MOUNTAIN DRIVE S.E., ALBERTVILLE, AL, 35950

Signature of
Role Plan administrator
Date 2021-07-20
Name of individual signing BARBARA KUCEWICZ-KOPYTA
KOPYTA INTERNAL MEDICINE, P.C. 401(K) PROFIT SHARING PLAN 2019 631266207 2020-08-10 KOPYTA INTERNAL MEDICINE, P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2568914577
Plan sponsor’s address 312 SAND MOUNTAIN DRIVE S.E., ALBERTVILLE, AL, 35950

Signature of
Role Plan administrator
Date 2020-08-09
Name of individual signing BARBARA KUCEWICZ-KOPYTA
KOPYTA INTERNAL MEDICINE, P.C. 401(K) PROFIT SHARING PLAN 2018 631266207 2019-08-19 KOPYTA INTERNAL MEDICINE, P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2568914577
Plan sponsor’s address 312 SAND MOUNTAIN DRIVE S.E., ALBERTVILLE, AL, 35950

Signature of
Role Plan administrator
Date 2019-08-17
Name of individual signing BARBARA KUCEWICZ-KOPYTA
KOPYTA INTERNAL MEDICINE, P.C. 401(K) PROFIT SHARING PLAN 2017 631266207 2018-07-08 KOPYTA INTERNAL MEDICINE, P.C. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2568914577
Plan sponsor’s address 312 SAND MOUNTAIN DRIVE S.E., ALBERTVILLE, AL, 35950

Signature of
Role Plan administrator
Date 2018-07-08
Name of individual signing BARBARA KUCEWICZ-KOPYTA
KOPYTA INTERNAL MEDICINE, P.C. 401(K) PROFIT SHARING PLAN 2016 631266207 2017-09-06 KOPYTA INTERNAL MEDICINE, P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2568914577
Plan sponsor’s address 312 SAND MOUNTAIN DRIVE S.E., ALBERTVILLE, AL, 35950

Signature of
Role Plan administrator
Date 2017-09-06
Name of individual signing BARBARA KUCEWICZ-KOPYTA
KOPYTA INTERNAL MEDICINE, P.C. 401(K) PROFIT SHARING PLAN 2015 631266207 2016-07-18 KOPYTA INTERNAL MEDICINE, P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2568914577
Plan sponsor’s address 312 SAND MOUNTAIN DRIVE S.E., ALBERTVILLE, AL, 35950

Signature of
Role Plan administrator
Date 2016-07-18
Name of individual signing CRAIG NOLAN
Role Employer/plan sponsor
Date 2016-07-18
Name of individual signing CRAIG NOLAN
KOPYTA INTERNAL MEDICINE, P.C. 401(K) PROFIT SHARING PLAN 2014 631266207 2015-06-16 KOPYTA INTERNAL MEDICINE, P.C. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2568914577
Plan sponsor’s address 312 SAND MOUNTAIN DRIVE S.E., ALBERTVILLE, AL, 35950

Signature of
Role Plan administrator
Date 2015-06-16
Name of individual signing CRAIG NOLAN
Role Employer/plan sponsor
Date 2015-06-16
Name of individual signing CRAIG NOLAN

Incorporator

Name Role
KUCEWICZ-KOPYTA, BARBARA E Incorporator

Agent

Name Role
KUCEWICZ-KOPYTA, BARBARA E Agent

Related by officers

No related officers

Related by address

ALBERTVILLE, AL

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Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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