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Community Urgent Care Lakeside North, Inc.

Details

Name: Community Urgent Care Lakeside North, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Exists
Date of registration: 01 Apr 2014 (11 years ago) (Companies founded in April 2014)
Entity Number: 000-306-446
Register Number: 000306446
ZIP code: 35976 (Companies in Marshall, 35976)
County: Marshall
Place of Formation: Cullman County
Registered Office Street Address: 38 ROWE DR.GUNTERSVILLE, AL 35976
Authorized Capital: 5,000 @ $1 PV

Activities PROFESSIONAL MEDICAL SERVICES THROUGH URGENT CARE CENTERS

National Provider Identifier

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

Contacts

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

form 5500

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
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 2021-10-12
Name of individual signing NAKITA MEREDITH
LAKESIDE NORTH 401(K) PLAN 2019 465264076 2020-05-14 COMMUNITY URGENT CARE, LAKESIDE NORTH, INC. 13
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

Director

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

Agent

Name Role
CAMPBELL, D. CLAY Agent

Incorporator

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