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Fairhope Pediatrics, Inc.

Details

Name: Fairhope Pediatrics, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Exists
Date of registration: 07 Jan 2009 (16 years ago)
Entity Number: 000-259-710
Register Number: 000259710
County: Baldwin
Place of Formation: Baldwin County
Principal Address: DAPHNE, AL
Registered Office Street Address: 9531 COLLIER LOOPDAPHNE, AL 36526
Registered Office Street Address ZIP Code: 36526
Authorized Capital: $1,000

Activities MEDICAL PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1740428663 2009-01-30 2013-06-26 19087 B GREENO ROAD, FAIRHOPE, AL, 36532, US 19087B GREENO RD, FAIRHOPE, AL, 365323899, US

Contacts
Phone +1 251-928-5568
Fax 2519282605

Authorized person
Name LESLIE K SKINNER
Role M.D./PRESIDENT
Phone 2519285568

Taxonomy
Taxonomy Code 208000000X - Pediatrics Physician
License Number 28869
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FAIRHOPE PEDIATRICS INC 401(K) PROFIT SHARING PLAN 2023 264061055 2024-05-15 FAIRHOPE PEDIATRICS 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2519285568
Plan sponsor’s address 19087 B GREENO ROAD, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2024-05-15
Name of individual signing JUDY MARCHBANKS
FAIRHOPE PEDIATRICS INC 401(K) PROFIT SHARING PLAN 2022 264061055 2023-06-27 FAIRHOPE PEDIATRICS 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2519285568
Plan sponsor’s address 19087 B GREENO ROAD, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2023-06-27
Name of individual signing LESLIE KATRINA SKINNER
FAIRHOPE PEDIATRICS INC 401(K) PROFIT SHARING PLAN 2021 264061055 2022-08-02 FAIRHOPE PEDIATRICS 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2519285568
Plan sponsor’s address 19087 B GREENO ROAD, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2022-08-02
Name of individual signing LESLIE K SKINNER
FAIRHOPE PEDIATRICS INC 401(K) PROFIT SHARING PLAN 2020 264061055 2021-10-04 FAIRHOPE PEDIATRICS 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2519285568
Plan sponsor’s address 19087 B GREENO ROAD, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2021-10-04
Name of individual signing LESLIE SKINNER
FAIRHOPE PEDIATRICS INC 401(K) PROFIT SHARING PLAN 2019 264061055 2020-08-31 FAIRHOPE PEDIATRICS 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2519285568
Plan sponsor’s address 19087 B GREENO ROAD, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2020-08-31
Name of individual signing KATRINA SKINNER
FAIRHOPE PEDIATRICS INC 401(K) PROFIT SHARING PLAN 2018 264061055 2019-06-28 FAIRHOPE PEDIATRICS 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2519285568
Plan sponsor’s address 19087 B GREENO ROAD, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2019-06-28
Name of individual signing KATRINA SKINNER
FAIRHOPE PEDIATRICS, INC. 401(K) PROFIT SHARING PLAN 2017 264061055 2018-08-21 FAIRHOPE PEDIATRICS, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2519285568
Plan sponsor’s address 19087 B GREENO ROAD, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2018-08-21
Name of individual signing LESLIE KATRINA SKINNER
FAIRHOPE PEDIATRICS, INC. 401(K) PROFIT SHARING PLAN 2016 264061055 2017-04-24 FAIRHOPE PEDIATRICS, INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2519285568
Plan sponsor’s address 19087 B GREENO ROAD, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2017-04-24
Name of individual signing LESLIE KATRINA SKINNER
FAIRHOPE PEDIATRICS, INC. 401(K) PROFIT SHARING PLAN 2015 264061055 2016-06-08 FAIRHOPE PEDIATRICS, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2519285568
Plan sponsor’s address 19087 B GREENO RD., FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2016-06-08
Name of individual signing LESLIE KATRINA SKINNER
FAIRHOPE PEDIATRICS, INC. 401(K) PROFIT SHARING PLAN 2014 264061055 2015-07-23 FAIRHOPE PEDIATRICS, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 621111
Sponsor’s telephone number 2519285568
Plan sponsor’s address 19087 B GREENO RD., FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2015-07-23
Name of individual signing LESLIE KATRINA SKINNER

Agent

Name Role
SKINNER, LESLIE K Agent

Incorporator

Name Role
SKINNER, LESLIE K Incorporator

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SKINNER, LESLIE K

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9531 COLLIER LOOPDAPHNE, AL 36526

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Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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