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North Alabama Medical Clinic, P.C.

Details

Name: North Alabama Medical Clinic, P.C.
Jurisdiction: Alabama
Legal type: Domestic Professional Corporation
Status: Exists
Date of registration: 02 Apr 2009 (16 years ago)
Entity Number: 000-260-547
Register Number: 000260547
Historical Names: Musarrat A. Yousuf, M.D., P.C.
County: Madison
Place of Formation: Madison County
Registered Office Street Address: 300 SUN TEMPLE DRIVEMADISON, AL 35758
Registered Office Street Address ZIP Code: 35758
Authorized Capital: $10,000

Activities MEDICAL PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1902049596 2009-04-12 2024-05-23 300 SUN TEMPLE DR, MADISON, AL, 357585919, US 300 SUN TEMPLE DR, MADISON, AL, 357585919, US

Contacts
Phone +1 256-325-9111
Fax 2563259113

Authorized person
Name DR. MUSARRAT AFROZE YOUSUF
Role PRESIDENT
Phone 2563259111

Taxonomy
Taxonomy Code 207R00000X - Internal Medicine Physician
License Number 23512
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NORTH ALABAMA MEDICAL CLINIC 401(K) P/S PLAN 2023 264595189 2024-10-02 NORTH ALABAMA MEDICAL CLINIC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 2563259111
Plan sponsor’s address 104 HIDDEN SPRINGS CT, MADISON, AL, 35758

Signature of
Role Plan administrator
Date 2024-10-02
Name of individual signing MUSARRAT YOUSUF
Valid signature Filed with authorized/valid electronic signature
NORTH ALABAMA MEDICAL CLINIC 401(K) P/S PLAN 2022 264595189 2023-06-14 NORTH ALABAMA MEDICAL CLINIC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 2563259111
Plan sponsor’s address 300 SUN TEMPLE DR, MADISON, AL, 35758

Plan administrator’s name and address
Administrator’s EIN 264595189
Plan administrator’s name NORTH ALABAMA MEDICAL CLINIC
Plan administrator’s address 300 SUN TEMPLE DR, MADISON, AL, 35758
Administrator’s telephone number 2563259111

Signature of
Role Plan administrator
Date 2023-06-14
Name of individual signing MUSARRAT AFROZE YOUSUF
NORTH ALABAMA MEDICAL CLINIC 401(K) P/S PLAN 2021 264595189 2022-06-22 NORTH ALABAMA MEDICAL CLINIC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 2563259111
Plan sponsor’s address 300 SUN TEMPLE DR, MADISON, AL, 35758

Plan administrator’s name and address
Administrator’s EIN 264595189
Plan administrator’s name NORTH ALABAMA MEDICAL CLINIC
Plan administrator’s address 300 SUN TEMPLE DR, MADISON, AL, 35758
Administrator’s telephone number 2563259111

Signature of
Role Plan administrator
Date 2022-06-22
Name of individual signing LORI HOTUNG
NORTH ALABAMA MEDICAL CLINIC 401(K) P/S PLAN 2020 264595189 2021-05-11 NORTH ALABAMA MEDICAL CLINIC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 2563259111
Plan sponsor’s address 300 SUN TEMPLE DR, MADISON, AL, 35758

Plan administrator’s name and address
Administrator’s EIN 264595189
Plan administrator’s name NORTH ALABAMA MEDICAL CLINIC
Plan administrator’s address 300 SUN TEMPLE DR, MADISON, AL, 35758
Administrator’s telephone number 2563259111

Signature of
Role Plan administrator
Date 2021-05-11
Name of individual signing LORI HOTUNG
NORTH ALABAMA MEDICAL CLINIC 401(K) P/S PLAN 2019 264595189 2020-06-08 NORTH ALABAMA MEDICAL CLINIC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 2563259111
Plan sponsor’s address 300 SUN TEMPLE DR, MADISON, AL, 35758

Plan administrator’s name and address
Administrator’s EIN 264595189
Plan administrator’s name NORTH ALABAMA MEDICAL CLINIC
Plan administrator’s address 300 SUN TEMPLE DR, MADISON, AL, 35758
Administrator’s telephone number 2563259111

Signature of
Role Plan administrator
Date 2020-06-08
Name of individual signing LORI HOTUNG
NORTH ALABAMA MEDICAL CLINIC 401(K) P/S PLAN 2018 264595189 2019-04-08 NORTH ALABAMA MEDICAL CLINIC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 2563259111
Plan sponsor’s address 300 SUN TEMPLE DR, MADISON, AL, 35758

Plan administrator’s name and address
Administrator’s EIN 264595189
Plan administrator’s name NORTH ALABAMA MEDICAL CLINIC
Plan administrator’s address 300 SUN TEMPLE DR, MADISON, AL, 35758
Administrator’s telephone number 2563259111

Signature of
Role Plan administrator
Date 2019-04-08
Name of individual signing LORI HOTUNG
NORTH ALABAMA MEDICAL CLINIC 401(K) P/S PLAN 2017 264595189 2018-06-18 NORTH ALABAMA MEDICAL CLINIC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 2563259111
Plan sponsor’s address 300 SUN TEMPLE DR, MADISON, AL, 35758

Plan administrator’s name and address
Administrator’s EIN 264595189
Plan administrator’s name NORTH ALABAMA MEDICAL CLINIC
Plan administrator’s address 300 SUN TEMPLE DR, MADISON, AL, 35758
Administrator’s telephone number 2563259111

Signature of
Role Plan administrator
Date 2018-06-18
Name of individual signing LORI HOTUNG
NORTH ALABAMA MEDICAL CLINIC 401(K) P/S PLAN 2016 264595189 2017-05-31 NORTH ALABAMA MEDICAL CLINIC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 2563259111
Plan sponsor’s address 300 SUN TEMPLE DR, MADISON, AL, 35758

Plan administrator’s name and address
Administrator’s EIN 264595189
Plan administrator’s name NORTH ALABAMA MEDICAL CLINIC
Plan administrator’s address 300 SUN TEMPLE DR, MADISON, AL, 35758
Administrator’s telephone number 2563259111

Signature of
Role Plan administrator
Date 2017-05-31
Name of individual signing LORI HOTUNG

Agent

Name Role Address
YOUSUF, MUSARRAT A Agent 540 HUGHES RD STE 9MADISON, AL 35758

Director

Name Role Address
YOUSUF, MUSARRAT A Director 540 HUGHES RD STE 9MADISON, AL 35758

Incorporator

Name Role Address
YOUSUF, MUSARRAT A Incorporator 540 HUGHES RD STE 9MADISON, AL 35758

Events

Event Date Event Type Old Value New Value
2015-09-02 Name Change Musarrat A. Yousuf, M.D., P.C. North Alabama Medical Clinic, P.C.

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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