| Name: | Etagbo Eta M.D., P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 12 Oct 2016 (8 years ago) (Companies founded in October 2016) |
| Entity Number: | 000-374-096 |
| Register Number: | 000374096 |
| Historical Names: |
Etas, P.C.
|
| ZIP code: | 35209 (Companies in Jefferson, 35209) |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Street Address: | 100 OXMOOR ROAD SUITE 110BIRMINGHAM, AL 35209 |
| Authorized Capital: | 10,000 |
Activities
MEDICAL DOCTORS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942849716 | 2019-12-27 | 2020-04-10 | 311 S 4TH ST, GADSDEN, AL, 359015212, US | 311 S 4TH ST, GADSDEN, AL, 359015212, US | |||||||||||||
|
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| Phone | +1 256-203-4713 |
Authorized person
| Name | ETAGBO ETA |
| Role | OWNER |
| Phone | 2562034713 |
Taxonomy
| Taxonomy Code | 207RN0300X - Nephrology Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THE KIDNEY MEDICAL CLINIC 401(K) PLAN | 2022 | 814184303 | 2023-10-13 | ETAGBO ETA M.D., P C. | 5 | |||||||||||||
|
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| THE KIDNEY MEDICAL CLINIC 401(K) PLAN | 2021 | 814184303 | 2022-10-04 | ETAGBO ETA M.D., P C. | 1 | |||||||||||||
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| THE KIDNEY MEDICAL CLINIC 401(K) PLAN | 2020 | 814184303 | 2021-10-06 | ETAGBO ETA M.D., P C. | 1 | |||||||||||||
|
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| Name | Role | Address |
|---|---|---|
| ETA, ETAGBO | Director | 5775 CARRINGTON LAKE PARKWAYTRUSSVILLE, AL 35173 |
| Name | Role | Address |
|---|---|---|
| MOSELEY, CHEYENNE | Incorporator | 9900 SPECTRUM DRIVEAUSTIN, TX 78717 |
| Name | Role | Address |
|---|---|---|
| ETA, ETAGBO MD | Agent | 311 SOUTH 4TH STREETGADSDEN, AL 35901 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2019-12-20 | Name Change | Etas, P.C. | Etagbo Eta M.D., P.C. |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
