| Name: | Community Urgent Care Lakeside North, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 01 Apr 2014 (11 years ago) |
| Entity Number: | 000-306-446 |
| Register Number: | 000306446 |
| County: | Marshall |
| Place of Formation: | Cullman County |
| Registered Office Street Address: | 38 ROWE DR.GUNTERSVILLE, AL 35976 |
| Registered Office Street Address ZIP Code: | 35976 |
| Authorized Capital: | 5,000 @ $1 PV |
Activities
PROFESSIONAL MEDICAL SERVICES THROUGH URGENT CARE CENTERS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013327527 | 2014-05-06 | 2020-02-24 | 38 ROWE DR, GUNTERSVILLE, AL, 359767367, US | 38 ROWE DR, GUNTERSVILLE, AL, 359767367, US | |||||||||||||||||||
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| Phone | +1 256-571-8460 |
| Fax | 2565718464 |
Authorized person
| Name | NAKITA MEREDITH |
| Role | PRACTICE MANAGER |
| Phone | 2565718581 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | No |
| Taxonomy Code | 261QU0200X - Urgent Care Clinic/Center |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LAKESIDE NORTH 401(K) PLAN | 2020 | 465264076 | 2021-10-12 | COMMUNITY URGENT CARE, LAKESIDE NORTH, INC. | 16 | |||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2021-10-12 |
| Name of individual signing | NAKITA MEREDITH |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 2019-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2565718460 |
| Plan sponsor’s address | 38 ROWE DRIVE, GUNTERSVILLE, AL, 35976 |
Signature of
| Role | Plan administrator |
| Date | 2020-05-14 |
| Name of individual signing | NAKITA MEREDITH |
| Name | Role | Address |
|---|---|---|
| YEAGER, NEIL CAMERON | Director | 101 1ST AVENUE NE SUITE 150CULLMAN, AL 35055 |
| CAMPBELL, DAVID CLAY | Director | 101 1ST AVENUE NE SUITE 150CULLMAN, AL 35055 |
| HORNSBY, JEB STUART | Director | 101 1ST AVENUE NE SUITE 150CULLMAN, AL 35055 |
| WEATHERLY, JESSE OREL | Director | 101 1ST AVENUE NE SUITE 150CULLMAN, AL 35055 |
| NYQUIST, STEPHEN CRAIG | Director | 101 1ST AVENUE NE SUITE 150CULLMAN, AL 35055 |
| DODD, RICHARD PAYNE | Director | 101 1ST AVENUE NE SUITE 150CULLMAN, AL 35055 |
| Name | Role |
|---|---|
| CAMPBELL, D. CLAY | Agent |
| Name | Role | Address |
|---|---|---|
| WEATHERLY, JESSE O III | Incorporator | 101 1ST AVENUE NE SUITE 150CULLMAN, AL 35055 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
