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Eastern Hospital Medicine, P.C.

Details

Name: Eastern Hospital Medicine, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 10 May 2006 (19 years ago)
Entity Number: 000-247-218
Register Number: 000247218
County: Shelby
Place of Formation: Jefferson County
Principal Address: BIRMINGHAM, AL
Registered Office Street Address: 7051 LAKE RUN DRBIRMINGHAM, AL 35242
Registered Office Street Address ZIP Code: 35242
Authorized Capital: $1,000

Activities MEDICAL PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1104859123 2006-07-10 2014-05-02 PO BOX 830674, MSC#716, BIRMINGHAM, AL, 352830674, US 50 MEDICAL PARK EAST DR, BIRMINGHAM, AL, 35235, US

Contacts

Phone +1 205-874-8300
Fax 2058748333
Phone +1 205-838-3000

Authorized person

Name DR. LEE T WIMBERLY
Role OWNER
Phone 2058748300

Taxonomy

Taxonomy Code 207R00000X - Internal Medicine Physician
Is Primary Yes

Other Provider Identifiers

Issuer MEDICARE RAILROAD
Number DF1683
Issuer MEDICAID
Number 529930180
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EASTERN HOSPITAL MEDICINE, P.C. 401(K) PLAN 2023 204849764 2024-10-15 EASTERN HOSPITAL MEDICINE, P.C. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2058383245
Plan sponsor’s address 7051 LAKE RUN DRIVE, BIRMINGHAM, AL, 35242
EASTERN HOSPITAL MEDICINE, P.C. 401(K) PLAN 2022 204849764 2023-08-21 EASTERN HOSPITAL MEDICINE, P.C. 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2058383245
Plan sponsor’s address 7051 LAKE RUN DRIVE, BIRMINGHAM, AL, 35242
EASTERN HOSPITAL MEDICINE, P.C. 401(K) PLAN 2021 204849764 2022-06-14 EASTERN HOSPITAL MEDICINE, P.C. 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2058383245
Plan sponsor’s address 7051 LAKE RUN DRIVE, BIRMINGHAM, AL, 35242
EASTERN HOSPITAL MEDICINE, P.C. 401(K) PLAN 2020 204849764 2021-07-29 EASTERN HOSPITAL MEDICINE, P.C. 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2058383245
Plan sponsor’s address 7051 LAKE RUN DRIVE, BIRMINGHAM, AL, 35242
EASTERN HOSPITAL MEDICINE, P.C. 401(K) PLAN 2019 204849764 2020-09-22 EASTERN HOSPITAL MEDICINE, P.C. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2058383245
Plan sponsor’s address 7051 LAKE RUN DRIVE, BIRMINGHAM, AL, 35242
EASTERN HOSPITAL MEDICINE, P.C. 401(K) PLAN 2018 204849764 2019-07-18 EASTERN HOSPITAL MEDICINE, P.C. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2058383245
Plan sponsor’s address 7051 LAKE RUN DRIVE, BIRMINGHAM, AL, 35242
EASTERN HOSPITAL MEDICINE, P.C. 401(K) PLAN 2018 204849764 2019-07-18 EASTERN HOSPITAL MEDICINE, P.C. 16
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2058383245
Plan sponsor’s address 7051 LAKE RUN DRIVE, BIRMINGHAM, AL, 35242
EASTERN HOSPITAL MEDICINE, P.C. 401(K) PLAN 2017 204849764 2018-10-03 EASTERN HOSPITAL MEDICINE, P.C. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2058383245
Plan sponsor’s address 7051 LAKE RUN DRIVE, BIRMINGHAM, AL, 35242
EASTERN HOSPITAL MEDICINE, P.C. 401(K) PLAN 2016 204849764 2017-10-05 EASTERN HOSPITAL MEDICINE, P.C. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2058383245
Plan sponsor’s address 7051 LAKE RUN DRIVE, BIRMINGHAM, AL, 35242
EASTERN HOSPITAL MEDICINE, P.C. 401(K) PLAN 2015 204849764 2016-09-28 EASTERN HOSPITAL MEDICINE, P.C. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2058383245
Plan sponsor’s address 7051 LAKE RUN DRIVE, BIRMINGHAM, AL, 35242

Agent

Name Role
WIMBERLY, LEE T Agent

Incorporator

Name Role Address
SCHIFF, GARY S Incorporator 420 20TH STREET NORTH, SUITE 1400BIRMINGHAM, AL 35203

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State