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Alabama Ear, Nose & Throat Specialists, LLC

Details

Name: Alabama Ear, Nose & Throat Specialists, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 13 Mar 2014 (11 years ago)
Entity Number: 000-298-803
Register Number: 000298803
County: Tuscaloosa
Place of Formation: Tuscaloosa County
Registered Office Street Address: 1902 KINGSGATE DRIVETUSCALOOSA, AL 35406
Registered Office Street Address ZIP Code: 35406

Activities MEDICAL PROFESSIONAL SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1023421468 2014-06-03 2014-09-03 302 MERCHANTS WALK, SUITE 100, TUSCALOOSA, AL, 354062290, US 302 MERCHANTS WALK, SUITE 100, TUSCALOOSA, AL, 354062290, US

Contacts
Phone +1 205-523-9300
Fax 2055239301

Authorized person
Name CRAIG M BENOIT
Role PARTNER
Phone 2055239300

Taxonomy
Taxonomy Code 207Y00000X - Otolaryngology Physician
License Number 26424
State AL
Is Primary Yes
Taxonomy Code 207YS0123X - Facial Plastic Surgery Physician
License Number 26424
State AL
Is Primary No

Other Provider Identifiers
Issuer MEDICAID
Number 161536
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ALABAMA EAR, NOSE & THROAT SPECIALISTS, LLC CASH BALANCE PLAN 2023 465660679 2024-10-07 ALABAMA EAR, NOSE & THROAT SPECIALISTS, LLC 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2021-01-01
Business code 621111
Sponsor’s telephone number 2055239300
Plan sponsor’s address 302 MERCHANTS WALK, STE. 100, TUSCALOOSA, AL, 35406

Signature of
Role Plan administrator
Date 2024-10-07
Name of individual signing CRAIG BENOIT
Valid signature Filed with authorized/valid electronic signature
ALABAMA EAR, NOSE & THROAT SPECIALISTS 401(K) PROFIT SHARING PLAN 2023 465660679 2024-07-15 ALABAMA EAR, NOSE, & THROAT SPECIALISTS, LLC 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2055239300
Plan sponsor’s address 302 MERCHANTS WALK, SUITE 100, TUSCALOOSA, AL, 35406

Signature of
Role Plan administrator
Date 2024-07-15
Name of individual signing GORDON SHIELDS
ALABAMA EAR, NOSE & THROAT SPECIALISTS 401(K) PROFIT SHARING PLAN 2022 465660679 2023-07-19 ALABAMA EAR, NOSE, & THROAT SPECIALISTS, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2055239300
Plan sponsor’s address 302 MERCHANTS WALK, SUITE 100, TUSCALOOSA, AL, 35406

Signature of
Role Plan administrator
Date 2023-07-19
Name of individual signing GORDON SHIELDS
ALABAMA EAR, NOSE & THROAT SPECIALISTS, LLC CASH BALANCE PLAN 2022 465660679 2023-09-19 ALABAMA EAR, NOSE & THROAT SPECIALISTS, LLC 10
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2021-01-01
Business code 621111
Sponsor’s telephone number 2055239300
Plan sponsor’s address 302 MERCHANTS WALK, STE. 100, TUSCALOOSA, AL, 35406

Signature of
Role Plan administrator
Date 2023-09-19
Name of individual signing CRAIG BENOIT
ALABAMA EAR, NOSE & THROAT SPECIALISTS, LLC CASH BALANCE PLAN 2021 465660679 2022-09-25 ALABAMA EAR, NOSE & THROAT SPECIALISTS, LLC 18
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2021-01-01
Business code 621111
Sponsor’s telephone number 2055239300
Plan sponsor’s address 302 MERCHANTS WALK, STE. 100, TUSCALOOSA, AL, 35406

Signature of
Role Plan administrator
Date 2022-09-25
Name of individual signing CRAIG BENOIT
ALABAMA EAR, NOSE & THROAT SPECIALISTS 401(K) PROFIT SHARING PLAN 2021 465660679 2022-08-04 ALABAMA EAR, NOSE, & THROAT SPECIALISTS, LLC 19
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2055239300
Plan sponsor’s address 302 MERCHANTS WALK, SUITE 100, TUSCALOOSA, AL, 35406

Signature of
Role Plan administrator
Date 2022-08-04
Name of individual signing CRAIG BENOIT
Role Employer/plan sponsor
Date 2022-08-04
Name of individual signing CRAIG BENOIT
ALABAMA EAR, NOSE & THROAT SPECIALISTS 401(K) PROFIT SHARING PLAN 2021 465660679 2022-08-04 ALABAMA EAR, NOSE, & THROAT SPECIALISTS, LLC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2055239300
Plan sponsor’s address 302 MERCHANTS WALK, SUITE 100, TUSCALOOSA, AL, 35406

Signature of
Role Plan administrator
Date 2022-08-04
Name of individual signing CRAIG BENOIT
ALABAMA EAR, NOSE & THROAT SPECIALISTS 401(K) PROFIT SHARING PLAN 2020 465660679 2021-06-21 ALABAMA EAR, NOSE, & THROAT SPECIALISTS, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2055239300
Plan sponsor’s address 302 MERCHANTS WALK, SUITE 100, TUSCALOOSA, AL, 35406

Signature of
Role Plan administrator
Date 2021-06-21
Name of individual signing CRAIG BENOIT
ALABAMA EAR, NOSE & THROAT SPECIALISTS 401(K) PROFIT SHARING PLAN 2019 465660679 2020-07-29 ALABAMA EAR, NOSE, & THROAT SPECIALISTS, LLC 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2055239300
Plan sponsor’s address 302 MERCHANTS WALK, SUITE 100, TUSCALOOSA, AL, 35406

Signature of
Role Plan administrator
Date 2020-07-29
Name of individual signing CRAIG BENOIT
ALABAMA EAR, NOSE & THROAT SPECIALISTS 401(K) PROFIT SHARING PLAN 2018 465660679 2019-07-25 ALABAMA EAR, NOSE, & THROAT SPECIALISTS, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 2055239300
Plan sponsor’s address 302 MERCHANTS WALK, SUITE 100, TUSCALOOSA, AL, 35406

Signature of
Role Plan administrator
Date 2019-07-25
Name of individual signing GORDON SHIELDS
Role Employer/plan sponsor
Date 2019-07-25
Name of individual signing CRAIG BENOIT

Agent

Name Role Address
BENOIT, CRAIG Agent 1902 KINGSGATE DRIVETUSCALOOSA, AL 35406

Organizer

Name Role Address
BENOIT, CRAIG Organizer 1902 KINGSGATE DRIVETUSCALOOSA, AL 35406
MAJEED, NATALIE Organizer 30 IVAN ALLEN JR BLVD NW SUITE 700ATLANTA, GA 30308
SHIELDS, GORDON Organizer 1031 GERMANTOWN ROADTUSCALOOSA, AL 35406

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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