| Name: | Southeastern Hospital Medicine, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 17 Oct 2016 (8 years ago) |
| Entity Number: | 000-374-482 |
| Register Number: | 000374482 |
| County: | Jefferson |
| Place of Formation: | Jefferson County |
| Registered Office Mailing Address: | PO BOX 531364BIRMINGHAM, AL 35253-1364 |
| Registered Office Street Address: | 7625 OLD SPRINGVILLE ROADTRUSSVILLE, AL 35173 |
| Registered Office Street Address ZIP Code: | 35173 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245772979 | 2016-11-11 | 2018-02-13 | PO BOX 530604, BIRMINGHAM, AL, 352530604, US | 800 SAINT VINCENTS DR, BIRMINGHAM, AL, 352051620, US | |||||||||||||||
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| Phone | +1 205-879-8294 |
| Fax | 2058798259 |
Authorized person
| Name | FELIX R DULANTO |
| Role | PHYSICIAN |
| Phone | 2058798294 |
Taxonomy
| Taxonomy Code | 208M00000X - Hospitalist Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SOUTHEASTERN HOSPITAL MEDICINE LLC 401(K) PLAN | 2023 | 814162570 | 2024-05-07 | SOUTHEASTERN HOSPITAL MEDICINE LLC | 1 | |||||||||||||||||||||||||||||
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| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2024-05-07 |
| Name of individual signing | QIAN LIU |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2022-04-11 |
| Business code | 621111 |
| Sponsor’s telephone number | 2057779203 |
| Plan sponsor’s address | 7625 OLD SPRINGVILLE ROAD, TRUSSVILLE, AL, 35173 |
Plan administrator’s name and address
| Administrator’s EIN | 474474775 |
| Plan administrator’s name | GUIDELINE, INC. |
| Plan administrator’s address | 1412 CHAPIN AVENUE, BURLINGAME, CA, 94010 |
| Administrator’s telephone number | 8882283491 |
Signature of
| Role | Plan administrator |
| Date | 2023-05-28 |
| Name of individual signing | CHRISTINE RIMER |
| Name | Role | Address |
|---|---|---|
| DULANTO, FELIX | Agent | 7625 OLD SPRINGVILLE ROADTRUSSVILLE, AL 35173 |
| Name | Role | Address |
|---|---|---|
| DULANTO, FELIX | Organizer | 7625 OLD SPRINGVILLE ROADTRUSSVILLE, AL 35173 |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
