| Name: | Panacea - O'Neill Medical Group, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 23 Feb 2017 (8 years ago) |
| Entity Number: | 000-384-371 |
| Register Number: | 000384371 |
| County: | Madison |
| Place of Formation: | Madison County |
| Registered Office Street Address: | 104 SPENRYN DRIVEMADISON, AL 35758 |
| Registered Office Street Address ZIP Code: | 35758 |
| Authorized Capital: | 1,000 @ $1/PV |
Activities
PROVIDE HEALTHCARE SERVICES TO CONSUMERS IN ALABAMA
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356870398 | 2017-06-05 | 2022-07-21 | 104 SPENRYN DR, MADISON, AL, 357581890, US | 104 SPENRYN DR, MADISON, AL, 357581890, US | |||||||||||||||
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| Phone | +1 256-772-4300 |
| Fax | 2567724302 |
Authorized person
| Name | TIERNAN O'NEILL |
| Role | OWNER/MANAGER |
| Phone | 2567724300 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PANACEA 401(K) PLAN | 2023 | 820612963 | 2024-10-08 | PANACEA-O'NEILL MEDICAL GROUP | 13 | |||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-10-08 |
| Name of individual signing | JEFFREY D BROWN |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2024-10-08 |
| Name of individual signing | JEFFREY D BROWN |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2565399641 |
| Plan sponsor’s address | 104 SPENRYN DR, MADISON, AL, 357581890 |
Signature of
| Role | Plan administrator |
| Date | 2023-09-27 |
| Name of individual signing | JEFFREY BROWN |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2565399641 |
| Plan sponsor’s address | 104 SPENRYN DRIVE, MADISON, AL, 35758 |
Signature of
| Role | Plan administrator |
| Date | 2022-07-29 |
| Name of individual signing | JEFFREY D BROWN |
| Role | Employer/plan sponsor |
| Date | 2022-07-29 |
| Name of individual signing | JEFFREY D BROWN |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2020-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2565399641 |
| Plan sponsor’s address | 104 SPENRYN DRIVE, MADISON, AL, 35758 |
Signature of
| Role | Plan administrator |
| Date | 2021-07-20 |
| Name of individual signing | JEFFREY D BROWN |
| Name | Role | Address |
|---|---|---|
| O'NEILL, PATRICK | Director | 3129 HADDONSTONE DRIVEHAMPTON COVE, AL 35763 |
| O'NIELL, TIERNAN | Director | 2029 VANDERBILT DRIVEHUNTSVILLE, AL 35801 |
| O'NEILL, SHANE | Director | 100 WASHINGTON STREETHUNTSVILLE, AL 35801 |
| Name | Role | Address |
|---|---|---|
| O'NIELL, TIERNAN | Agent | 2029 VANDERBILT DRIVEHUNTSVILLE, AL 35801 |
| Name | Role | Address |
|---|---|---|
| GIVHAN, SAMUEL H | Incorporator | 100 WASHINGTON STREETHUNTSVILE, AL 35801 |
Date of last update: 13 Aug 2024
Sources: Alabama Secretary of State
