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Alabama Skin Institute, Inc.

Details

Name: Alabama Skin Institute, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Dissolved
Date of registration: 22 May 2001 (24 years ago) (Companies founded in May 2001)
Date of dissolution: 15 Apr 2020
Entity Number: 000-216-967
Register Number: 000216967
ZIP code: 35242 (Companies in Shelby, 35242)
County: Shelby
Place of Formation: Jefferson County
Principal Address: BIRMINGHAM, AL
Registered Office Street Address: 134 LAKE COLONY LANEBIRMINGHAM, AL 35242
Authorized Capital: $500

Activities PROVIDE SERVICES REGARDING SKIN CARE/TREATMENT OF DISEASES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1972761377 2008-06-02 2008-06-02 6285 PARK SOUTH DR, BESSEMER, AL, 350225670, US 6285 PARK SOUTH DR, BESSEMER, AL, 350225670, US

Contacts
Phone +1 205-426-5507
Fax 2054265563

Authorized person
Name DR. JASON L LOCKRIDGE
Role PHYSICIAN/OWNER
Phone 2054265507

Taxonomy
Taxonomy Code 174400000X - Specialist
License Number 22467
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ALABAMA SKIN INSTITUTE, INC. 401(K) PLAN 2018 631275633 2019-06-19 ALABAMA SKIN INSTITUTE, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621399
Sponsor’s telephone number 2054265507
Plan sponsor’s address 6285 PARK SOUTH DRIVE, BESSEMER, AL, 35022

Signature of
Role Plan administrator
Date 2019-06-19
Name of individual signing JASON LOCKRIDGE
ALABAMA SKIN INSTITUTE, INC. 401(K) PLAN 2017 631275633 2018-10-02 ALABAMA SKIN INSTITUTE, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621399
Sponsor’s telephone number 2054265507
Plan sponsor’s address 6285 PARK SOUTH DRIVE, BESSEMER, AL, 35022

Signature of
Role Plan administrator
Date 2018-10-02
Name of individual signing JASON LOCKRIDGE
ALABAMA SKIN INSTITUTE, INC. 401(K) PLAN 2016 631275633 2017-10-12 ALABAMA SKIN INSTITUTE, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621399
Sponsor’s telephone number 2054265507
Plan sponsor’s address 6285 PARK SOUTH DRIVE, BESSEMER, AL, 35022

Signature of
Role Plan administrator
Date 2017-10-12
Name of individual signing JASON LOCKRIDGE
ALABAMA SKIN INSTITUTE, INC. 401(K) PLAN 2016 631275633 2017-10-12 ALABAMA SKIN INSTITUTE, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621399
Sponsor’s telephone number 2054265507
Plan sponsor’s address 6285 PARK SOUTH DRIVE, BESSEMER, AL, 35022

Signature of
Role Plan administrator
Date 2017-10-12
Name of individual signing JASON LOCKRIDGE
ALABAMA SKIN INSTITUTE, INC. 401(K) PLAN 2015 631275633 2016-10-12 ALABAMA SKIN INSTITUTE, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621399
Sponsor’s telephone number 2054265507
Plan sponsor’s address 6285 PARK SOUTH DRIVE, BESSEMER, AL, 35022

Signature of
Role Plan administrator
Date 2016-10-12
Name of individual signing JASON LOCKRIDGE
ALABAMA SKIN INSTITUTE, INC. 401(K) PLAN 2014 631275633 2017-10-12 ALABAMA SKIN INSTITUTE, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621399
Sponsor’s telephone number 2053235440
Plan sponsor’s address 6285 PARK SOUTH DRIVE, BESSEMER, AL, 35022

Signature of
Role Plan administrator
Date 2017-10-12
Name of individual signing JASON LOCKRIDGE
ALABAMA SKIN INSTITUTE, INC. 401(K) PLAN 2013 631275633 2017-10-12 ALABAMA SKIN INSTITUTE, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621399
Sponsor’s telephone number 2054265507
Plan sponsor’s address 6285 PARK SOUTH DRIVE, BESSEMER, AL, 35022

Signature of
Role Plan administrator
Date 2017-10-12
Name of individual signing JASON LOCKRIDGE
ALABAMA SKIN INSTITUTE, INC. 401(K) PLAN 2013 631275633 2014-09-04 ALABAMA SKIN INSTITUTE, INC. 8
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621399
Sponsor’s telephone number 2054265507
Plan sponsor’s address 6285 PARK SOUTH DRIVE, BESSEMER, AL, 35022

Signature of
Role Plan administrator
Date 2014-09-04
Name of individual signing JASON LOCKRIDGE
ALABAMA SKIN INSTITUTE, INC, 401(K) PLAN 2012 631275633 2013-07-17 ALABAMA SKIN INSTITUTE, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621399
Sponsor’s telephone number 2054265507
Plan sponsor’s address 6285 PARK SOUTH DRIVE, BESSEMER, AL, 35022

Signature of
Role Plan administrator
Date 2013-07-10
Name of individual signing JASON LOCKRIDGE
ALABAMA SKIN INSTITUTE, INC, 401(K) PLAN 2011 631275633 2012-10-03 ALABAMA SKIN INSTITUTE, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621399
Sponsor’s telephone number 2054265507
Plan sponsor’s address 6285 PARK SOUTH DRIVE, BESSEMER, AL, 35022

Plan administrator’s name and address
Administrator’s EIN 631275633
Plan administrator’s name ALABAMA SKIN INSTITUTE, INC.
Plan administrator’s address 6285 PARK SOUTH DRIVE, BESSEMER, AL, 35022
Administrator’s telephone number 2054265507

Signature of
Role Plan administrator
Date 2012-10-03
Name of individual signing JASON LOCKRIDGE

Incorporator

Name Role
LOCKRIDGE, JASON L Incorporator

Agent

Name Role
LOCKRIDGE, JASON L Agent

Related by officers

No related officers

Related by address

BIRMINGHAM, AL

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Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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