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Urgent Care Northwest, LLC

Details

Name: Urgent Care Northwest, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 23 Feb 2007 (18 years ago) (Companies founded in February 2007)
Entity Number: 000-251-378
Register Number: 000251378
Historical Names: Jasper Urgent Care Clinic, P.C.
Urgent Care Northwest, P.C.
ZIP code: 35406 (Companies in Tuscaloosa, 35406)
County: Tuscaloosa
Place of Formation: Tuscaloosa County
Principal Address: 9021 FORRESTAL DRIVETUSCALOOSA, AL 35406
Registered Office Street Address: 9021 FORRESTAL DRTUSCALOOSA, AL 35406

Activities MEDICAL PRACTICE

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
N6L3LC9DXNL7 2021-11-17 2708 HIGHWAY 78 E, JASPER, AL, 35501, 3430, USA 2708 HIGHWAY 78 E, JASPER, AL, 35501, 3430, USA

Business Information
Congressional District 04
State/Country of Incorporation AL, USA
Activation Date 2020-11-24
Initial Registration Date 2020-11-17
Entity Start Date 2007-12-10
Fiscal Year End Close Date Dec 31

Service Classifications
NAICS Codes 621111
Product and Service Codes Q999

Points of Contacts
Electronic Business
Title PRIMARY POC
Name AMANDA M CORDELL
Role CLINICAL DIRECTOR
Address 2708 HIGHWAY 78 E, JASPER, AL, 35501, 3430, USA
Government Business
Title PRIMARY POC
Name AMANDA M CORDELL
Role CLINICAL DIRECTOR
Address 2708 HIGHWAY 78 E, PO BOX 708, JASPER, AL, 35501, 3430, USA
Past Performance Information not Available

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1548456494 2007-09-24 2022-07-05 2708 HIGHWAY 78 E, JASPER, AL, 355013430, US 2708 HIGHWAY 78 E, JASPER, AL, 355013430, US

Contacts
Phone +1 205-387-2253
Fax 2053872405
Fax 2053872269

Authorized person
Name DR. DEAN ROBERT NADEN
Role MEDICAL DIRECTOR/OWNER
Phone 2053872253

Taxonomy
Taxonomy Code 207Q00000X - Family Medicine Physician
Is Primary Yes
Taxonomy Code 261QU0200X - Urgent Care Clinic/Center
Is Primary No

Other Provider Identifiers
Issuer MEDICAID
Number 186249
State AL
Issuer RAILROAD MEDICARE
Number DG9096
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
URGENT CARE NORTHWEST RETIREMENT PLAN 2023 208911105 2024-07-11 URGENT CARE NORTHWEST 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-05-02
Business code 621111
Sponsor’s telephone number 2053872253
Plan sponsor’s address 2708 HIGHWAY 78 E, JASPER, AL, 35501

Signature of
Role Plan administrator
Date 2024-07-11
Name of individual signing DEAN NADEN
URGENT CARE NORTHWEST RETIREMENT PLAN 2022 208911105 2023-07-18 URGENT CARE NORTHWEST 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-05-02
Business code 621111
Sponsor’s telephone number 2053872253
Plan sponsor’s address 2708 HIGHWAY 78 E, JASPER, AL, 35501

Signature of
Role Plan administrator
Date 2023-07-18
Name of individual signing DEAN NADEN
URGENT CARE NORTHWEST RETIREMENT PLAN 2021 208911105 2022-08-17 URGENT CARE NORTHWEST 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-05-02
Business code 621111
Sponsor’s telephone number 2053872253
Plan sponsor’s address 2708 HIGHWAY 78 E, JASPER, AL, 35501

Signature of
Role Plan administrator
Date 2022-08-17
Name of individual signing DEAN NADEN
URGENT CARE NORTHWEST RETIREMENT PLAN 2020 208911105 2021-05-10 URGENT CARE NORTHWEST 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-05-02
Business code 621111
Sponsor’s telephone number 2053872253
Plan sponsor’s address 2708 HIGHWAY 78 E, JASPER, AL, 35501

Plan administrator’s name and address
Administrator’s EIN 208911105
Plan administrator’s name URGENT CARE NORTHWEST
Plan administrator’s address 2708 HIGHWAY 78 E, JASPER, AL, 35501
Administrator’s telephone number 2053872253

Signature of
Role Plan administrator
Date 2021-05-10
Name of individual signing DEAN NADEN
URGENT CARE NORTHWEST RETIREMENT PLAN 2019 208911105 2021-10-05 URGENT CARE NORTHWEST 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-05-02
Business code 621111
Sponsor’s telephone number 2053872253
Plan sponsor’s address 2708 HIGHWAY 78 E, JASPER, AL, 35501

Plan administrator’s name and address
Administrator’s EIN 208911105
Plan administrator’s name URGENT CARE NORTHWEST
Plan administrator’s address 2708 HIGHWAY 78 E, JASPER, AL, 35501
Administrator’s telephone number 2053872253
URGENT CARE NORTHWEST RETIREMENT PLAN 2018 208911105 2019-10-15 URGENT CARE NORTHWEST 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-05-02
Business code 621111
Sponsor’s telephone number 2053872253
Plan sponsor’s address 2708 HIGHWAY 78 E, JASPER, AL, 35501

Signature of
Role Plan administrator
Date 2019-10-15
Name of individual signing DEAN NADEN
URGENT CARE NORTHWEST RETIREMENT PLAN 2017 208911105 2018-10-09 URGENT CARE NORTHWEST 41
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-05-02
Business code 621111
Sponsor’s telephone number 2053872253
Plan sponsor’s address 2708 HIGHWAY 78 E, JASPER, AL, 35501

Plan administrator’s name and address
Administrator’s EIN 208911105
Plan administrator’s name URGENT CARE NORTHWEST
Plan administrator’s address 2708 HIGHWAY 78 E, JASPER, AL, 35501
Administrator’s telephone number 2053872253

Signature of
Role Plan administrator
Date 2018-10-09
Name of individual signing DEAN NADEN
URGENT CARE NORTHWEST RETIREMENT PLAN 2016 208911105 2017-07-05 URGENT CARE NORTHWEST 39
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-05-02
Business code 621111
Sponsor’s telephone number 2053872253
Plan sponsor’s address 2708 HIGHWAY 78 E, JASPER, AL, 35501

Plan administrator’s name and address
Administrator’s EIN 208911105
Plan administrator’s name URGENT CARE NORTHWEST
Plan administrator’s address 2708 HIGHWAY 78 E, JASPER, AL, 35501
Administrator’s telephone number 2053872253

Signature of
Role Plan administrator
Date 2017-07-05
Name of individual signing DEAN NADEN
URGENT CARE NORTHWEST RETIREMENT PLAN 2015 208911105 2016-10-12 URGENT CARE NORTHWEST 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-05-02
Business code 621111
Sponsor’s telephone number 2053872253
Plan sponsor’s address 2708 HIGHWAY 78 E, JASPER, AL, 35501

Plan administrator’s name and address
Administrator’s EIN 208911105
Plan administrator’s name URGENT CARE NORTHWEST
Plan administrator’s address 2708 HIGHWAY 78 E, JASPER, AL, 35501
Administrator’s telephone number 2053872253

Signature of
Role Plan administrator
Date 2016-10-12
Name of individual signing DEAN NADEN
URGENT CARE NORTHWEST RETIREMENT PLAN 2014 208911105 2015-10-12 URGENT CARE NORTHWEST 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-05-02
Business code 621111
Sponsor’s telephone number 2053872253
Plan sponsor’s address 2708 HIGHWAY 78 E, JASPER, AL, 35501

Plan administrator’s name and address
Administrator’s EIN 208911105
Plan administrator’s name URGENT CARE NORTHWEST
Plan administrator’s address 2708 HIGHWAY 78 E, JASPER, AL, 35501
Administrator’s telephone number 2053872253

Signature of
Role Plan administrator
Date 2015-10-12
Name of individual signing DEAN NADEN

Agent

Name Role Address
LOVELY, PERRY Agent 9021 FORRESTAL DRIVETUSCALOOSA, AL 35406

Organizer

Name Role Address
MIXON, GREG Organizer 44 INVERNESS CENTER PARKWAY, SUITE 140BIRMINGHAM, AL 35242

Events

Event Date Event Type Old Value New Value
2024-03-18 Name Change Urgent Care Northwest, P.C. Urgent Care Northwest, LLC
2007-08-27 Name Change Jasper Urgent Care Clinic, P.C. Urgent Care Northwest, P.C.

Related by officers

LOVELY, PERRY

JDB Construction Co., Inc. Management Connections, Inc. PLMCM, LLC MedCenter Hoover, P.C. PERRY LOVELY, M.D., L.L.C. LLMN, L.L.C. Lovely Land, L.L.C. Bigham-Lovely Properties, L.L.C. PLM, LLC

MIXON, GREG

Woodrow House 4512, LLC Constantine International Foods, LLC Tuscaloosa MedCenter South, LLC Tuscaloosa MedCenter North, LLC MedCenter Demopolis, LLC Pharmacy of Madison, LLC Truemark Metals, LLC GaaS LLC BM Investments LLC MedCenter Primary Care, LLC

Related by address

9021 FORRESTAL DRTUSCALOOSA, AL 35406

PERRY LOVELY, M.D., L.L.C. LLMN, L.L.C. Lovely Land, L.L.C.

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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