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Etowah Gastroenterology Associates P.C.

Details

Name: Etowah Gastroenterology Associates P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 29 Jul 2004 (20 years ago) (Companies founded in July 2004)
Entity Number: 000-236-547
Register Number: 000236547
Historical Names: Anniston G.I. Consultants, P.C.
ZIP code: 35903 (Companies in Etowah, 35903)
County: Etowah
Place of Formation: Calhoun County
Registered Office Street Address: 1026 GOODYEAR AVENUE SUITE 201GADSDEN, AL 35903
Registered Office Mailing Address: P O BOX 8090GADSDEN, AL 35903
Authorized Capital: $100

Activities MEDICINE PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1750562492 2007-11-23 2023-01-12 1026 GOODYEAR AVE, SUITE 201, GADSDEN, AL, 359031194, US 1026 GOODYEAR AVE, SUITE 201, GADSDEN, AL, 359031194, US

Contacts
Phone +1 256-467-4477
Fax 2564674830

Authorized person
Name VIPUL T AMIN
Role PROVIDER
Phone 2564674477

Taxonomy
Taxonomy Code 174400000X - Specialist
License Number MD23716
State AL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 009969840
State AL
Issuer BCBS
Number 51523153
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ETOWAH GASTROENTEROLOGY ASSOCIATES, P.C. RETIREMENT PLAN 2023 201426381 2024-03-19 ETOWAH GASTROENTEROLOGY ASSOCIATES, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-03-01
Business code 621111
Sponsor’s telephone number 2565048684
Plan sponsor’s address 1026 GOODYEAR AVENUE, SUITE 201, GADSDEN, AL, 35903
ETOWAH GASTROENTEROLOGY ASSOCIATES, P.C. CASH BALANCE PLAN 2022 201426381 2023-09-26 ETOWAH GASTROENTEROLOGY ASSOCIATES, P.C. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2565048684
Plan sponsor’s address 1026 GOODYEAR AVENUE, SUITE 201, GADSDEN, AL, 35903
ETOWAH GASTROENTEROLOGY ASSOCIATES, P.C. RETIREMENT PLAN 2022 201426381 2023-03-21 ETOWAH GASTROENTEROLOGY ASSOCIATES, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-03-01
Business code 621111
Sponsor’s telephone number 2565048684
Plan sponsor’s address 1026 GOODYEAR AVENUE, SUITE 201, GADSDEN, AL, 35903
ETOWAH GASTROENTEROLOGY ASSOCIATES, P.C. CASH BALANCE PLAN 2022 201426381 2023-03-21 ETOWAH GASTROENTEROLOGY ASSOCIATES, P.C. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2565048684
Plan sponsor’s address 1026 GOODYEAR AVENUE, SUITE 201, GADSDEN, AL, 35903
ETOWAH GASTROENTEROLOGY ASSOCIATES, P.C. RETIREMENT PLAN 2021 201426381 2022-03-15 ETOWAH GASTROENTEROLOGY ASSOCIATES, P.C. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-03-01
Business code 621111
Sponsor’s telephone number 2565048684
Plan sponsor’s address 1026 GOODYEAR AVENUE, SUITE 201, GADSDEN, AL, 35903
ETOWAH GASTROENTEROLOGY ASSOCIATES, P.C. CASH BALANCE PLAN 2021 201426381 2022-07-28 ETOWAH GASTROENTEROLOGY ASSOCIATES, P.C. 2
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2565048684
Plan sponsor’s address 1026 GOODYEAR AVENUE, SUITE 201, GADSDEN, AL, 35903
ETOWAH GASTROENTEROLOGY ASSOCIATES, P.C. CASH BALANCE PLAN 2020 201426381 2021-06-29 ETOWAH GASTROENTEROLOGY ASSOCIATES, P.C. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2565048684
Plan sponsor’s address 1026 GOODYEAR AVENUE, SUITE 201, GADSDEN, AL, 35903
ETOWAH GASTROENTEROLOGY ASSOCIATES, P.C. RETIREMENT PLAN 2020 201426381 2021-05-27 ETOWAH GASTROENTEROLOGY ASSOCIATES, P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-03-01
Business code 621111
Sponsor’s telephone number 2565048684
Plan sponsor’s address 1026 GOODYEAR AVENUE, SUITE 201, GADSDEN, AL, 35903
ETOWAH GASTROENTEROLOGY ASSOCIATES, P.C. RETIREMENT PLAN 2019 201426381 2020-06-01 ETOWAH GASTROENTEROLOGY ASSOCIATES, P.C. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-03-01
Business code 621111
Sponsor’s telephone number 2565048684
Plan sponsor’s address 1026 GOODYEAR AVENUE, SUITE 201, GADSDEN, AL, 35903
ETOWAH GASTROENTEROLOGY ASSOCIATES, P.C. CASH BALANCE PLAN 2019 201426381 2020-07-09 ETOWAH GASTROENTEROLOGY ASSOCIATES, P.C. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2565048684
Plan sponsor’s address 1026 GOODYEAR AVENUE, SUITE 201, GADSDEN, AL, 35903

Agent

Name Role
AMIN, VIPUL T Agent

Incorporator

Name Role Address
DANIEL, W JOHN Incorporator 1530 3RD AVE S AB 820BIRMINGHAM, AL 35294-0108

Events

Event Date Event Type Old Value New Value
2012-06-26 Name Change Anniston G.I. Consultants, P.C. Etowah Gastroenterology Associates P.C.

Related by officers

DANIEL, W JOHN

UAB Hospital Management, LLC Pen Point Solutions, Inc. Deep Root, Inc. Fresh Fruit, Inc. Brookstone Cardiology, P.C. Innovative Healthcare Consulting, Inc. Platinum Automotive, Inc. DEJAA-Hoover, Inc. Alabama Surgeons, P.C. Amplify Health, Inc.

Related by address

No related companies by address

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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