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Mayfair Internal Medicine, Inc.

Details

Name: Mayfair Internal Medicine, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Dissolved
Date of registration: 05 Jan 2007 (18 years ago)
Date of dissolution: 15 Dec 2021
Entity Number: 000-250-666
Register Number: 000250666
County: Jefferson
Place of Formation: Jefferson County
Registered Office Street Address: 3106 INDEPENDENCE DRBIRMINGHAM, AL 35209
Registered Office Street Address ZIP Code: 35209
Principal Address: BIRMINGHAM, AL
Authorized Capital: 4,000

Activities MEDICAL PRACTICE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MAYFAIR INTERNAL MEDICINE, INC. 401(K) P/S PLAN 2020 208181189 2021-07-20 MAYFAIR INTERNAL MEDICINE, INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2052838737
Plan sponsor’s address 3106 INDEPENDENCE DRIVE, BIRMINGHAM, AL, 35209

Plan administrator’s name and address
Administrator’s EIN 208181189
Plan administrator’s name MAYFAIR INTERNAL MEDICINE, INC.
Plan administrator’s address 3106 INDEPENDENCE DRIVE, BIRMINGHAM, AL, 35209
Administrator’s telephone number 2052838737

Signature of
Role Plan administrator
Date 2021-07-20
Name of individual signing ROBERT MURRAY
MAYFAIR INTERNAL MEDICINE, INC. 401(K) P/S PLAN 2020 208181189 2021-10-25 MAYFAIR INTERNAL MEDICINE, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2052838737
Plan sponsor’s address 3106 INDEPENDENCE DRIVE, BIRMINGHAM, AL, 35209

Signature of
Role Plan administrator
Date 2021-10-24
Name of individual signing R MICHAEL MURRAY
MAYFAIR INTERNAL MEDICINE, INC. 401(K) P/S PLAN 2019 208181189 2020-06-03 MAYFAIR INTERNAL MEDICINE, INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2058717007
Plan sponsor’s address 3106 INDEPENDENCE DRIVE, BIRMINGHAM, AL, 35209

Plan administrator’s name and address
Administrator’s EIN 208181189
Plan administrator’s name MAYFAIR INTERNAL MEDICINE, INC.
Plan administrator’s address 3106 INDEPENDENCE DRIVE, BIRMINGHAM, AL, 35209
Administrator’s telephone number 2058717007

Signature of
Role Plan administrator
Date 2020-06-03
Name of individual signing DEBBIE RANDALL
MAYFAIR INTERNAL MEDICINE, INC. 401(K) P/S PLAN 2018 208181189 2019-03-05 MAYFAIR INTERNAL MEDICINE, INC. 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2058717007
Plan sponsor’s address 3106 INDEPENDENCE DRIVE, BIRMINGHAM, AL, 35209

Plan administrator’s name and address
Administrator’s EIN 208181189
Plan administrator’s name MAYFAIR INTERNAL MEDICINE, INC.
Plan administrator’s address 3106 INDEPENDENCE DRIVE, BIRMINGHAM, AL, 35209
Administrator’s telephone number 2058717007

Signature of
Role Plan administrator
Date 2019-03-05
Name of individual signing DEBBIE RANDALL
MAYFAIR INTERNAL MEDICINE, INC. 401(K) P/S PLAN 2017 208181189 2018-03-23 MAYFAIR INTERNAL MEDICINE, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2058717007
Plan sponsor’s address 3106 INDEPENDENCE DRIVE, BIRMINGHAM, AL, 35209

Plan administrator’s name and address
Administrator’s EIN 208181189
Plan administrator’s name MAYFAIR INTERNAL MEDICINE, INC.
Plan administrator’s address 3106 INDEPENDENCE DRIVE, BIRMINGHAM, AL, 35209
Administrator’s telephone number 2058717007

Signature of
Role Plan administrator
Date 2018-03-23
Name of individual signing DEBBIE RANDALL
MAYFAIR INTERNAL MEDICINE, INC. 401(K) P/S PLAN 2016 208181189 2017-05-25 MAYFAIR INTERNAL MEDICINE, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2058717007
Plan sponsor’s address 3106 INDEPENDENCE DRIVE, BIRMINGHAM, AL, 35209

Plan administrator’s name and address
Administrator’s EIN 208181189
Plan administrator’s name MAYFAIR INTERNAL MEDICINE, INC.
Plan administrator’s address 3106 INDEPENDENCE DRIVE, BIRMINGHAM, AL, 35209
Administrator’s telephone number 2058717007

Signature of
Role Plan administrator
Date 2017-05-25
Name of individual signing DEBBIE RANDALL
MAYFAIR INTERNAL MEDICINE, INC. 401(K) P/S PLAN 2015 208181189 2016-03-03 MAYFAIR INTERNAL MEDICINE, INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2058717007
Plan sponsor’s address 3106 INDEPENDENCE DRIVE, BIRMINGHAM, AL, 35209

Plan administrator’s name and address
Administrator’s EIN 208181189
Plan administrator’s name MAYFAIR INTERNAL MEDICINE, INC.
Plan administrator’s address 3106 INDEPENDENCE DRIVE, BIRMINGHAM, AL, 35209
Administrator’s telephone number 2058717007

Signature of
Role Plan administrator
Date 2016-03-03
Name of individual signing DEBBIE RANDALL
MAYFAIR INTERNAL MEDICINE, INC. 401(K) P/S PLAN 2014 208181189 2015-04-30 MAYFAIR INTERNAL MEDICINE, INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2058717007
Plan sponsor’s address 3106 INDEPENDENCE DRIVE, BIRMINGHAM, AL, 35209

Plan administrator’s name and address
Administrator’s EIN 208181189
Plan administrator’s name MAYFAIR INTERNAL MEDICINE, INC.
Plan administrator’s address 3106 INDEPENDENCE DRIVE, BIRMINGHAM, AL, 35209
Administrator’s telephone number 2058717007

Signature of
Role Plan administrator
Date 2015-04-30
Name of individual signing DEBBIE RANDALL
MAYFAIR INTERNAL MEDICINE, INC. 401(K) P/S PLAN 2013 208181189 2014-04-21 MAYFAIR INTERNAL MEDICINE, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2058717007
Plan sponsor’s address 3106 INDEPENDENCE DRIVE, BIRMINGHAM, AL, 35209

Plan administrator’s name and address
Administrator’s EIN 208181189
Plan administrator’s name MAYFAIR INTERNAL MEDICINE, INC.
Plan administrator’s address 3106 INDEPENDENCE DRIVE, BIRMINGHAM, AL, 35209
Administrator’s telephone number 2058717007

Signature of
Role Plan administrator
Date 2014-04-21
Name of individual signing DEBBIE RANDALL
MAYFAIR INTERNAL MEDICINE, INC. 401(K) P/S PLAN 2012 208181189 2013-04-30 MAYFAIR INTERNAL MEDICINE, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2058717007
Plan sponsor’s address 3106 INDEPENDENCE DRIVE, BIRMINGHAM, AL, 35209

Plan administrator’s name and address
Administrator’s EIN 208181189
Plan administrator’s name MAYFAIR INTERNAL MEDICINE, INC.
Plan administrator’s address 3106 INDEPENDENCE DRIVE, BIRMINGHAM, AL, 35209
Administrator’s telephone number 2058717007

Signature of
Role Plan administrator
Date 2013-04-30
Name of individual signing DEBBIE RANDALL

Incorporator

Name Role
MURRAY, ROBERT MICHAEL Incorporator
BROWNE, RAYMOND JAMES Incorporator
MAYS, MICHAEL CLAY Incorporator
PATTERSON, WILLIAM GUY Incorporator

Agent

Name Role
MURRAY, ROBERT MICHAEL Agent

Related by officers

No related officers

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Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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