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Maxillofacial Surgery Center of Huntsville, Inc.

Details

Name: Maxillofacial Surgery Center of Huntsville, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Exists
Date of registration: 29 Jul 2004 (20 years ago)
Entity Number: 000-236-686
Register Number: 000236686
County: Madison
Place of Formation: Madison County
Principal Address: HUNTSVILLE, AL
Registered Office Street Address: 1107 GLENEAGLES DRHUNTSVILLE, AL 35801
Registered Office Street Address ZIP Code: 35801
Authorized Capital: $1,000
Paid Share Capital: $1,000

Activities ANY LAWFUL ACTIVITY

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1972716710 2007-05-08 2008-01-29 1107 GLENEAGLES DR SW, HUNTSVILLE, AL, 358016405, US 1107 GLENEAGLES DR SW, HUNTSVILLE, AL, 358016405, US

Contacts
Phone +1 256-882-3312
Fax 2568829472

Authorized person
Name LEROY A KAMELCHUK
Role DDS MD
Phone 2568823312

Taxonomy
Taxonomy Code 261QS0112X - Oral and Maxillofacial Surgery Clinic/Center
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MAXILLOFACIAL SURGERY CENTER - 401K 2021 861116209 2022-06-21 MAXILLOFACIAL SURGERY CENTER OF HUNTSVILLE, INC. 5
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-11-19
Business code 621210
Sponsor’s telephone number 2568823312
Plan sponsor’s mailing address 1107 GLENEAGLES DRIVE SW, HUNTSVILLE, AL, 35801
Plan sponsor’s address 1107 GLENEAGLES DRIVE SW, HUNTSVILLE, AL, 35801

Number of participants as of the end of the plan year
Active participants 5
Number of participants with account balances as of the end of the plan year 5
MAXILLOFACIAL SURGERY CENTER - 401K 2020 861116209 2021-08-24 MAXILLOFACIAL SURGERY CENTER OF HUNTSVILLE, INC. 5
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-11-19
Business code 621210
Sponsor’s telephone number 2568823312
Plan sponsor’s mailing address 1107 GLENEAGLES DRIVE SW, HUNTSVILLE, AL, 35801
Plan sponsor’s address 1107 GLENEAGLES DRIVE SW, HUNTSVILLE, AL, 35801

Number of participants as of the end of the plan year
Active participants 4
Other retired or separated participants entitled to future benefits 1
Number of participants with account balances as of the end of the plan year 5
MAXILLOFACIAL SURGERY CENTER - 401K 2019 861116209 2020-07-23 MAXILLOFACIAL SURGERY CENTER OF HUNTSVILLE, INC. 5
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-11-19
Business code 621210
Sponsor’s telephone number 2568823312
Plan sponsor’s mailing address 1107 GLENEAGLES DRIVE SW, HUNTSVILLE, AL, 35801
Plan sponsor’s address 1107 GLENEAGLES DRIVE SW, HUNTSVILLE, AL, 35801

Number of participants as of the end of the plan year
Active participants 5
Number of participants with account balances as of the end of the plan year 5
MAXILLOFACIAL SURGERY CENTER - 401K 2018 861116209 2019-10-02 MAXILLOFACIAL SURGERY CENTER OF HUNTSVILLE, INC. 3
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-11-19
Business code 621210
Sponsor’s telephone number 2568823312
Plan sponsor’s mailing address 1107 GLENEAGLES DRIVE SW, HUNTSVILLE, AL, 35801
Plan sponsor’s address 1107 GLENEAGLES DRIVE SW, HUNTSVILLE, AL, 35801

Number of participants as of the end of the plan year
Active participants 5
MAXILLOFACIAL SURGERY CENTER - 401K 2017 861116209 2018-07-19 MAXILLOFACIAL SURGERY CENTER OF HUNTSVILLE, INC. 4
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-11-19
Business code 621210
Sponsor’s telephone number 2568823312
Plan sponsor’s mailing address 1107 GLENEAGLES DRIVE SW, HUNTSVILLE, AL, 35801
Plan sponsor’s address 1107 GLENEAGLES DRIVE SW, HUNTSVILLE, AL, 35801

Number of participants as of the end of the plan year
Active participants 3
MAXILLOFACIAL SURGERY CENTER - 401K 2016 861116209 2017-07-28 MAXILLOFACIAL SURGERY CENTER OF HUNTSVILLE, INC. 3
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-11-19
Business code 621210
Sponsor’s telephone number 2568823312
Plan sponsor’s mailing address 1107 GLENEAGLES DRIVE SW, HUNTSVILLE, AL, 35801
Plan sponsor’s address 1107 GLENEAGLES DRIVE SW, HUNTSVILLE, AL, 35801

Number of participants as of the end of the plan year
Active participants 3
Other retired or separated participants entitled to future benefits 1
MAXILLOFACIAL SURGERY CENTER - 401K 2015 861116209 2016-07-28 MAXILLOFACIAL SURGERY CENTER OF HUNTSVILLE, INC. 3
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-11-19
Business code 621210
Sponsor’s telephone number 2568823312
Plan sponsor’s mailing address 1107 GLENEAGLES DRIVE SW, HUNTSVILLE, AL, 35801
Plan sponsor’s address 1107 GLENEAGLES DRIVE SW, HUNTSVILLE, AL, 35801

Number of participants as of the end of the plan year
Number of participants with account balances as of the end of the plan year 3
MAXILLOFACIAL SURGERY CENTER - 401K 2014 861116209 2015-07-29 MAXILLOFACIAL SURGERY CENTER OF HUNTSVILLE, INC. 5
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-11-19
Business code 621210
Sponsor’s telephone number 2568823312
Plan sponsor’s mailing address 1107 GLENEAGLES DRIVE SW, HUNTSVILLE, AL, 35801
Plan sponsor’s address 1107 GLENEAGLES DRIVE SW, HUNTSVILLE, AL, 35801

Number of participants as of the end of the plan year
Active participants 3
Number of participants with account balances as of the end of the plan year 3
MAXILLOFACIAL SURGERY CENTER - 401K 2013 861116209 2014-07-21 MAXILLOFACIAL SURGERY CENTER OF HUNTSVILLE, INC. 5
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-11-19
Business code 621210
Sponsor’s telephone number 2568823312
Plan sponsor’s mailing address 1107 GLENEAGLES DRIVE SW, HUNTSVILLE, AL, 35801
Plan sponsor’s address 1107 GLENEAGLES DRIVE SW, HUNTSVILLE, AL, 35801

Number of participants as of the end of the plan year
Active participants 5
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0
Number of participants with account balances as of the end of the plan year 5
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 1
MAXILLOFACIAL SURGERY CENTER - 401K 2012 861116209 2013-07-18 MAXILLOFACIAL SURGERY CENTER OF HUNTSVILLE, INC. 6
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2002-11-19
Business code 621210
Sponsor’s telephone number 2568823312
Plan sponsor’s mailing address 1107 GLENEAGLES DRIVE SW, HUNTSVILLE, AL, 35801
Plan sponsor’s address 1107 GLENEAGLES DRIVE SW, HUNTSVILLE, AL, 35801

Number of participants as of the end of the plan year
Active participants 5
Number of participants with account balances as of the end of the plan year 8
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 2

Signature of
Role Plan administrator
Date 2013-07-09
Name of individual signing LEE KAMELCHUK
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role
KAMELCHUK, LEROY ANTHONY Agent

Incorporator

Name Role
KAMELCHUK, LEROY ANTHONY Incorporator

Related by officers

No related officers

Related by address

HUNTSVILLE, AL

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Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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