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Cahaba Pain and Spine Care, LLC

Details

Name: Cahaba Pain and Spine Care, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 11 Apr 2016 (9 years ago)
Entity Number: 000-360-023
Register Number: 000360023
County: Jefferson
Place of Formation: Jefferson County
Registered Office Street Address: 2010 PATTON CHAPEL ROAD SUITE 200HOOVER, AL 35216
Registered Office Street Address ZIP Code: 35216

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1073960431 2016-05-16 2024-01-29 2010 PATTON CHAPEL RD STE 200, HOOVER, AL, 352165784, US 2010 PATTON CHAPEL RD, SUITE 200, HOOVER, AL, 352165782, US

Contacts
Phone +1 205-208-9001
Fax 2052080031
Fax 2052089001

Authorized person
Name RICHARD BRIAN THOMA
Role PHYSICIAN
Phone 2052089001

Taxonomy
Taxonomy Code 207L00000X - Anesthesiology Physician
License Number 27941
State AL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 191618
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CAHABA PAIN & SPINE 401(K) PLAN 2023 812273536 2024-07-31 CAHABA PAIN AND SPINE CARE, LLC 39
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 2052089001
Plan sponsor’s address 2010 PATTON CHAPEL ROAD, SUITE 200, HOOVER, AL, 35216

Signature of
Role Plan administrator
Date 2024-07-31
Name of individual signing STEVE HARRELL
CAHABA PAIN & SPINE 401(K) PLAN 2022 812273536 2023-08-30 CAHABA PAIN AND SPINE CARE, LLC 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 2052089001
Plan sponsor’s address 2010 PATTON CHAPEL ROAD, SUITE 200, HOOVER, AL, 35216

Signature of
Role Plan administrator
Date 2023-08-30
Name of individual signing STEVE HARRELL
CAHABA PAIN & SPINE 401(K) PLAN 2021 812273536 2022-10-04 CAHABA PAIN AND SPINE CARE, LLC 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 2052089001
Plan sponsor’s address 2010 PATTON CHAPEL ROAD, SUITE 200, HOOVER, AL, 35216

Signature of
Role Plan administrator
Date 2022-10-04
Name of individual signing STEVE HARRELL
CAHABA PAIN & SPINE 401(K) PLAN 2020 812273536 2021-07-29 CAHABA PAIN AND SPINE CARE, LLC 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 2052089001
Plan sponsor’s address 2010 PATTON CHAPEL ROAD, SUITE 200, HOOVER, AL, 35216

Signature of
Role Plan administrator
Date 2021-07-29
Name of individual signing STEVE HARRELL
CAHABA PAIN & SPINE 401(K) PLAN 2019 812273536 2020-10-07 CAHABA PAIN AND SPINE CARE, LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 2052089001
Plan sponsor’s address 2010 PATTON CHAPEL ROAD, SUITE 200, HOOVER, AL, 35216

Signature of
Role Plan administrator
Date 2020-10-07
Name of individual signing STEVE HARRELL
CAHABA PAIN & SPINE 401(K) PLAN 2018 812273536 2019-09-19 CAHABA PAIN AND SPINE CARE, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 2052089001
Plan sponsor’s address 2010 PATTON CHAPEL ROAD, SUITE 200, HOOVER, AL, 35216

Signature of
Role Plan administrator
Date 2019-09-19
Name of individual signing STEVE HARRELL

Agent

Name Role
THOMA, RICHARD B Agent

Organizer

Name Role Address
LEVY, JACK B Organizer 1819 FIFTH AVENUE NBIRMINGHAM, AL 35203

Related by officers

THOMA, RICHARD B

Alliance Anesthesia Consultants, LLC Restore Vein and Wellness LLC

LEVY, JACK B

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Related by address

No related companies by address

Date of last update: 03 Aug 2024

Sources: Alabama Secretary of State

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