| Name: | Covington Medical Associates PC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 12 Oct 2005 (19 years ago) |
| Entity Number: | 000-243-738 |
| Register Number: | 000243738 |
| County: | Covington |
| Place of Formation: | Covington County |
| Registered Office Street Address: | 301 MEDICAL DRIVE STE BANDALUSIA, AL 36420 |
| Registered Office Street Address ZIP Code: | 36420 |
| Principal Address: | ANDALUSIA, AL |
| Authorized Capital: | 2,000 |
Activities
ANY LAWFUL ACTIVITY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629093240 | 2006-07-13 | 2009-10-07 | PO BOX 1608, ANDALUSIA, AL, 364201227, US | 115 MEDICAL PARK DR, ANDALUSIA, AL, 364205323, US | |||||||||||||||||||||||||||
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| Phone | +1 334-222-3640 |
| Fax | 3342223660 |
Authorized person
| Name | MRS. LYNN FREE |
| Role | INSURANCE |
| Phone | 3342223640 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009936874 |
| State | AL |
| Issuer | MEDICAID |
| Number | 009936876 |
| State | AL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| COVINGTON MEDICAL ASSOCIATES 401(K) RETIREMENT PLAN | 2010 | 203610199 | 2011-04-28 | COVINGTON MEDICAL ASSOCIATES, PC | 8 | |||||||||||||||||||||||||||||
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| Administrator’s EIN | 203610199 |
| Plan administrator’s name | COVINGTON MEDICAL ASSOCIATES, PC |
| Plan administrator’s address | 115 MEDICAL PARK DRIVE, ANDALUSIA, AL, 36420 |
| Administrator’s telephone number | 3342223640 |
Signature of
| Role | Plan administrator |
| Date | 2011-04-28 |
| Name of individual signing | JEFFREY STRINGER |
| Name | Role |
|---|---|
| GACHA, SAMUEL A | Agent |
| Name | Role |
|---|---|
| SARRIA, KARLA | Incorporator |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
