| Name: | Northridge Internal Medicine, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Dissolved |
| Date of registration: | 01 Sep 2005 (19 years ago) |
| Date of dissolution: | 22 Dec 2009 |
| Entity Number: | 000-243-252 |
| Register Number: | 000243252 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Principal Address: | TUSCALOOSA, AL |
| Registered Office Street Address: | 940 VALLEY FORGE RDTUSCALOOSA, AL 35406 |
| Registered Office Street Address ZIP Code: | 35406 |
| Authorized Capital: | $5,000 |
Activities
INTERNAL MEDICINE PRACTICE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578595047 | 2006-07-07 | 2020-08-22 | 1649 MCFARLAND BLVD N STE 203, TUSCALOOSA, AL, 354062270, US | 1649 MCFARLAND BLVD N STE 203, TUSCALOOSA, AL, 354062270, US | |||||||||||||||
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| Phone | +1 205-759-5600 |
| Fax | 2057595001 |
Authorized person
| Name | JO SMITH |
| Role | OFFICE MANAGER |
| Phone | 2057595600 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NORTHRIDGE INTERNAL MEDICINE, P.C. 401(K) PLAN | 2009 | 203407025 | 2011-11-04 | NORTHRIDGE INTERNAL MEDICINE, P.C. | 6 | |||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 203407025 |
| Plan administrator’s name | NORTHRIDGE INTERNAL MEDICINE, P.C. |
| Plan administrator’s address | 940 VALLEY FORGE ROAD, TUSACLOOSA, AL, 35406 |
| Administrator’s telephone number | 2057524080 |
Signature of
| Role | Plan administrator |
| Date | 2011-11-04 |
| Name of individual signing | JOSEPH G. STEWART, JR., M.D. |
| Role | Employer/plan sponsor |
| Date | 2011-11-04 |
| Name of individual signing | JOSEPH G. STEWART, JR., M.D. |
| Name | Role |
|---|---|
| STEWART, J GRIER JR | Agent |
| Name | Role |
|---|---|
| STEWART, J GRIER JR | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
