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Etowah Pediatrics, P.C.

Details

Name: Etowah Pediatrics, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 04 Jan 2006 (19 years ago) (Companies founded in January 2006)
Entity Number: 000-245-005
Register Number: 000245005
ZIP code: 35906 (Companies in Etowah, 35906)
County: Etowah
Place of Formation: Etowah County
Principal Address: RAINBOW CITY, AL
Registered Office Street Address: 170 INDEPENDENT DR.RAINBOW CITY, AL 35906
Authorized Capital: $10,000
Paid Share Capital: $1,000

Activities MEDICAL PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1972529808 2006-07-14 2014-08-28 170 INDEPENDENT DR, RAINBOW CITY, AL, 359063286, US 170 INDEPENDENT DR, RAINBOW CITY, AL, 359063286, US

Contacts
Phone +1 256-413-1467
Fax 2564131470

Authorized person
Name DR. BENJAMIN HESTER
Role PHYSICIAN
Phone 2564131467

Taxonomy
Taxonomy Code 208000000X - Pediatrics Physician
License Number 23664
State AL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 529926830
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ETOWAH PEDIATRICS 401(K) PROFIT SHARING PLAN 2023 204028164 2024-09-11 ETOWAH PEDIATRICS, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2564131467
Plan sponsor’s address 170 INDEPENDENT DRIVE, RAINBOW CITY, AL, 35906

Signature of
Role Plan administrator
Date 2024-09-11
Name of individual signing SHELLY HESTER
Valid signature Filed with authorized/valid electronic signature
ETOWAH PEDIATRICS 401(K) PROFIT SHARING PLAN 2022 204028164 2023-10-13 ETOWAH PEDIATRICS, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2564131467
Plan sponsor’s address 170 INDEPENDENT DRIVE, RAINBOW CITY, AL, 35906

Signature of
Role Plan administrator
Date 2023-10-13
Name of individual signing SHELLY HESTER
ETOWAH PEDIATRICS 401(K) PROFIT SHARING PLAN 2021 204028164 2022-07-28 ETOWAH PEDIATRICS, P.C. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2564131467
Plan sponsor’s address 170 INDEPENDENT DRIVE, RAINBOW CITY, AL, 35906

Signature of
Role Plan administrator
Date 2022-07-28
Name of individual signing SHELLY HESTER
ETOWAH PEDIATRICS 401(K) PROFIT SHARING PLAN 2020 204028164 2021-07-16 ETOWAH PEDIATRICS, P.C. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2564131467
Plan sponsor’s address 170 INDEPENDENT DRIVE, RAINBOW CITY, AL, 35906

Signature of
Role Plan administrator
Date 2021-07-16
Name of individual signing SHELLY HESTER
ETOWAH PEDIATRICS 401(K) PROFIT SHARING PLAN 2019 204028164 2020-06-04 ETOWAH PEDIATRICS, P.C. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2564131467
Plan sponsor’s address 170 INDEPENDENT DRIVE, RAINBOW CITY, AL, 35906

Signature of
Role Plan administrator
Date 2020-06-04
Name of individual signing SHELLY HESTER
ETOWAH PEDIATRICS 401(K) PROFIT SHARING PLAN 2018 204028164 2019-06-13 ETOWAH PEDIATRICS, P.C. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2564131467
Plan sponsor’s address 170 INDEPENDENT DRIVE, RAINBOW CITY, AL, 35906

Signature of
Role Plan administrator
Date 2019-06-12
Name of individual signing SHELLY HESTER
ETOWAH PEDIATRICS 401(K) PROFIT SHARING PLAN 2017 204028164 2018-07-10 ETOWAH PEDIATRICS, P.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2564131467
Plan sponsor’s address 170 INDEPENDENT DRIVE, RAINBOW CITY, AL, 35906

Signature of
Role Plan administrator
Date 2018-07-10
Name of individual signing SHELLY HESTER
ETOWAH PEDIATRICS 401(K) PROFIT SHARING PLAN 2016 204028164 2017-09-22 ETOWAH PEDIATRICS, P.C. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2564131467
Plan sponsor’s address 170 INDEPENDENT DRIVE, RAINBOW CITY, AL, 35906

Signature of
Role Plan administrator
Date 2017-09-22
Name of individual signing SHELLY HESTER
ETOWAH PEDIATRICS 401(K) PROFIT SHARING PLAN 2015 204028164 2016-10-18 ETOWAH PEDIATRICS, P.C. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2564131467
Plan sponsor’s address 170 INDEPENDENT DRIVE, RAINBOW CITY, AL, 35906

Signature of
Role Plan administrator
Date 2016-10-18
Name of individual signing SHELLY HESTER
ETOWAH PEDIATRICS 401(K) PROFIT SHARING PLAN 2015 204028164 2016-10-12 ETOWAH PEDIATRICS, P.C. 9
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2564131467
Plan sponsor’s address 170 INDEPENDENT DRIVE, RAINBOW CITY, AL, 35906

Signature of
Role Plan administrator
Date 2016-10-12
Name of individual signing SHELLY HESTER

Agent

Name Role Address
HESTER, BENJAMIN C Agent 115 CANTERBERRY LANEGADSDEN, AL 35901

Incorporator

Name Role Address
HESTER, BENJAMIN C Incorporator 115 CANTERBERRY LANEGADSDEN, AL 35901

Related by officers

HESTER, BENJAMIN C

BHS Properties, LLC

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Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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