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Princeton Sleep Medicine, LLC

Details

Name: Princeton Sleep Medicine, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Dissolved
Date of registration: 03 Aug 2010 (14 years ago)
Date of dissolution: 10 Dec 2021
Entity Number: 000-300-293
Register Number: 000300293
County: Jefferson
Place of Formation: Jefferson County
Principal Address: BIRMINGHAM, AL
Registered Office Street Address: 3409 OAK CANYON DRBIRMINGHAM, AL 35243
Registered Office Street Address ZIP Code: 35243

Activities PRACTICE OF PULMONARY/SLEEP MEDICINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1194031161 2010-08-27 2012-07-12 801 PRINCETON AVE SW, POB I; SUITE 332, BIRMINGHAM, AL, 352111310, US 801 PRINCETON AVE SW, POB I; SUITE 332, BIRMINGHAM, AL, 352111310, US

Contacts
Phone +1 205-781-3752
Fax 2057887244

Authorized person
Name STUART J. PADOVE
Role PRESIDENT
Phone 2059676142

Taxonomy
Taxonomy Code 207RS0012X - Sleep Medicine (Internal Medicine) Physician
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 1194031161/122048
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PRINCETON SLEEP MEDICINE, LLC 401(K) RETIREMENT PLAN 2020 273160075 2021-07-26 PRINCETON SLEEP MEDICINE, LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-11-01
Business code 621111
Sponsor’s telephone number 2059141012
Plan sponsor’s address 3409 OAK CANYON DR, BIRMINGHAM, AL, 35243

Signature of
Role Plan administrator
Date 2021-07-26
Name of individual signing STUART PADOVE
PRINCETON SLEEP MEDICINE, LLC 401(K) RETIREMENT PLAN 2019 273160075 2020-07-15 PRINCETON SLEEP MEDICINE, LLC 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-11-01
Business code 621111
Sponsor’s telephone number 2059141012
Plan sponsor’s address 3409 OAK CANYON DR, BIRMINGHAM, AL, 35243

Signature of
Role Plan administrator
Date 2020-07-15
Name of individual signing STUART PADOVE
PRINCETON SLEEP MEDICINE, LLC 401(K) RETIREMENT PLAN 2018 273160075 2019-05-17 PRINCETON SLEEP MEDICINE, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-11-01
Business code 621111
Sponsor’s telephone number 2057813752
Plan sponsor’s address 833 PRINCETON AVENUE SW, POB I SUITE 332, BIRMINGHAM, AL, 35211

Signature of
Role Plan administrator
Date 2019-05-17
Name of individual signing STUART PADOVE
PRINCETON SLEEP MEDICINE, LLC 401(K) RETIREMENT PLAN 2017 273160075 2018-07-27 PRINCETON SLEEP MEDICINE, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-11-01
Business code 621111
Sponsor’s telephone number 2057813752
Plan sponsor’s address 833 PRINCETON AVENUE SW, POB I SUITE 332, BIRMINGHAM, AL, 35211

Signature of
Role Plan administrator
Date 2018-07-27
Name of individual signing STUART PADOVE
PRINCETON SLEEP MEDICINE, LLC 401(K) RETIREMENT PLAN 2016 273160075 2017-07-06 PRINCETON SLEEP MEDICINE, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-11-01
Business code 621111
Sponsor’s telephone number 2057813752
Plan sponsor’s address 833 PRINCETON AVENUE SW, POB I SUITE 332, BIRMINGHAM, AL, 35211

Signature of
Role Plan administrator
Date 2017-07-06
Name of individual signing STUART PADOVE
PRINCETON SLEEP MEDICINE, LLC 401(K) RETIREMENT PLAN 2015 273160075 2016-07-13 PRINCETON SLEEP MEDICINE, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-11-01
Business code 621111
Sponsor’s telephone number 2057813752
Plan sponsor’s address 833 PRINCETON AVENUE SW, POB I SUITE 332, BIRMINGHAM, AL, 35211

Signature of
Role Plan administrator
Date 2016-07-13
Name of individual signing STUART PADOVE
PRINCETON SLEEP MEDICINE, LLC 401(K) RETIREMENT PLAN 2014 273160075 2015-07-17 PRINCETON SLEEP MEDICINE, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-11-01
Business code 621111
Sponsor’s telephone number 2057813752
Plan sponsor’s address 833 PRINCETON AVENUE SW, POB I SUITE 332, BIRMINGHAM, AL, 35211

Signature of
Role Plan administrator
Date 2015-07-17
Name of individual signing STUART PADOVE
PRINCETON SLEEP MEDICINE, LLC 401(K) RETIREMENT PLAN 2013 273160075 2014-05-13 PRINCETON SLEEP MEDICINE, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-11-01
Business code 621111
Sponsor’s telephone number 2057813752
Plan sponsor’s address 833 PRINCETON AVENUE SW, POB I SUITE 332, BIRMINGHAM, AL, 35211

Signature of
Role Plan administrator
Date 2014-05-13
Name of individual signing STUART PADOVE
PRINCETON SLEEP MEDICINE, LLC 401(K) RETIREMENT PLAN 2012 273160075 2013-07-26 PRINCETON SLEEP MEDICINE, LLC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-11-01
Business code 621111
Sponsor’s telephone number 2057813752
Plan sponsor’s address 833 PRINCETON AVENUE SW, POB III SUITE 200B, BIRMINGHAM, AL, 35211

Signature of
Role Plan administrator
Date 2013-07-26
Name of individual signing STUART PADOVE
PRINCETON SLEEP MEDICINE, LLC 401(K) RETIREMENT PLAN 2011 273160075 2012-07-13 PRINCETON SLEEP MEDICINE, LLC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-11-01
Business code 621111
Sponsor’s telephone number 2057813752
Plan sponsor’s address 833 PRINCETON AVENUE SW, POB III SUITE 200B, BIRMINGHAM, AL, 35211

Plan administrator’s name and address
Administrator’s EIN 273160075
Plan administrator’s name PRINCETON SLEEP MEDICINE, LLC
Plan administrator’s address 833 PRINCETON AVENUE SW, POB III SUITE 200B, BIRMINGHAM, AL, 35211
Administrator’s telephone number 2057813752

Signature of
Role Plan administrator
Date 2012-07-13
Name of individual signing STUART PADOVE

Agent

Name Role
PADOVE, STUART J Agent

Member

Name Role
PADOVE, STUART J Member

Related by officers

No related officers

Related by address

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Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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