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BEAR CREEK FAMILY PRACTICE, LLC

Details

Name: BEAR CREEK FAMILY PRACTICE, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 03 Feb 2014 (11 years ago) (Companies founded in February 2014)
Entity Number: 000-296-001
Register Number: 000296001
Historical Names: Mitt Lary Family Practice, LLC
ZIP code: 35405 (Companies in Tuscaloosa, 35405)
County: Tuscaloosa
Place of Formation: Tuscaloosa County
Registered Office Street Address: 7005 6TH AVENUETUSCALOOSA, AL 35405

Activities PROVIDE PRIMARY HEALTH CARE/MEDICAL SERVICES IN CLINICAL SETTING

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1811380090 2015-03-11 2015-03-11 7005 6TH AVE, TUSCALOOSA, AL, 354053990, US 7005 6TH AVE, TUSCALOOSA, AL, 354053990, US

Contacts
Phone +1 205-345-4862
Fax 2053455178

Authorized person
Name DR. MOHAMMAD F. ARYANPURE
Role OWNER/DIRECTOR
Phone 2053454862

Taxonomy
Taxonomy Code 207Q00000X - Family Medicine Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MITT LARY FAMILY PRACTICE CASH BALANCE PLAN 2023 141997293 2024-10-15 MITT LARY FAMILY PRACTICE LLC 16
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2057220650
Plan sponsor’s address 4815 ROSE BLVD, NORTHPORT, AL, 35475

Signature of
Role Plan administrator
Date 2024-10-15
Name of individual signing FRANCINA TAYLOR
Valid signature Filed with authorized/valid electronic signature
MITT LARY FAMILY PRACTICE RETIREMENT PLAN 2023 141997293 2024-07-31 MITT LARY FAMILY PRACTICE LLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2057220650
Plan sponsor’s address 4815 ROSE BLVD, NORTHPORT, AL, 35475

Signature of
Role Plan administrator
Date 2024-07-31
Name of individual signing FRANCINA TAYLOR
MITT LARY FAMILY PRACTICE RETIREMENT PLAN 2022 141997293 2023-09-22 MITT LARY FAMILY PRACTICE LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2057220650
Plan sponsor’s address 4815 ROSE BLVD, NORTHPORT, AL, 35475

Signature of
Role Plan administrator
Date 2023-09-22
Name of individual signing FRANCINA TAYLOR
MITT LARY FAMILY PRACTICE CASH BALANCE PLAN 2021 141997293 2024-05-16 MITT LARY FAMILY PRACTICE LLC 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2057220650
Plan sponsor’s address 4815 ROSE BLVD, NORTHPORT, AL, 35475

Signature of
Role Plan administrator
Date 2024-05-16
Name of individual signing FRANCINA TAYLOR
MITT LARY FAMILY PRACTICE RETIREMENT PLAN 2021 141997293 2022-06-20 MITT LARY FAMILY PRACTICE LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2057220650
Plan sponsor’s address 4815 ROSE BLVD, NORTHPORT, AL, 35475

Signature of
Role Plan administrator
Date 2022-06-20
Name of individual signing FRANCINA TAYLOR
MITT LARY FAMILY PRACTICE CASH BALANCE PLAN 2020 141997293 2021-10-14 MITT LARY FAMILY PRACTICE LLC 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2057220650
Plan sponsor’s address 4815 ROSE BLVD, NORTHPORT, AL, 35475

Signature of
Role Plan administrator
Date 2021-10-14
Name of individual signing MALIKA ARYANPURE
MITT LARY FAMILY PRACTICE RETIREMENT PLAN 2020 141997293 2021-07-07 MITT LARY FAMILY PRACTICE LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2057220650
Plan sponsor’s address 4815 ROSE BLVD, NORTHPORT, AL, 35475

Signature of
Role Plan administrator
Date 2021-07-07
Name of individual signing MALIKA ARYANPURE
MITT LARY FAMILY PRACTICE CASH BALANCE PLAN 2019 141997293 2020-10-15 MITT LARY FAMILY PRACTICE LLC 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2057220650
Plan sponsor’s address 4815 ROSE BLVD, NORTHPORT, AL, 35475
MITT LARY FAMILY PRACTICE RETIREMENT PLAN 2019 141997293 2020-10-15 MITT LARY FAMILY PRACTICE LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2057220650
Plan sponsor’s address 4815 ROSE BLVD, NORTHPORT, AL, 35475
MITT LARY FAMILY PRACTICE RETIREMENT PLAN 2018 141997293 2019-10-15 MITT LARY FAMILY PRACTICE LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621210
Sponsor’s telephone number 2057220650
Plan sponsor’s address 4815 ROSE BLVD, NORTHPORT, AL, 35475

Agent

Name Role Address
ARYANPURE, MOHAMMAD F Agent 7005 6TH AVENUETUSCALOOSA, AL 35405

Member

Name Role Address
ARYANPURE, MOHAMMAD F Member 7005 6TH AVENUETUSCALOOSA, AL 35405

Organizer

Name Role Address
ARYANPURE, MOHAMMAD FAWAD Organizer 7005 6TH AVENUETUSCALOOSA, AL 35405
JONES, THOMAS MATTHEW Organizer PO BOX 1939TUSCALOOSA, AL 35403-1939

Events

Event Date Event Type Old Value New Value
2015-01-02 Name Change Mitt Lary Family Practice, LLC BEAR CREEK FAMILY PRACTICE, LLC

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Related by address

7005 6TH AVENUETUSCALOOSA, AL 35405

MFA, LLC

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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