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Pisgah Medical Clinic, L.L.C.

Details

Name: Pisgah Medical Clinic, L.L.C.
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Dissolved
Date of registration: 27 Dec 2004 (20 years ago) (Companies founded in December 2004)
Date of dissolution: 16 Dec 2011
Entity Number: 000-458-403
Register Number: 000458403
ZIP code: 35765 (Companies in Jackson, 35765)
County: Jackson
Place of Formation: Jackson County
Principal Address: PISGAH, AL
Registered Office Street Address: 6110 COUNTY RD 88PISGAH, AL 35765

Activities PRACTICE MEDICINE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PISGAH MEDICAL CLINIC 401(K) PROFIT SHARING PLAN AND TRUST 2012 631077810 2013-10-07 PISGAH MEDICAL CLINIC 8
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 2564511250
Plan sponsor’s address 6110 COUNTY ROAD 88, PISGAH, AL, 35765

Signature of

Role Plan administrator
Date 2013-10-07
Name of individual signing MUHAMMAD ATA
Role Employer/plan sponsor
Date 2013-10-07
Name of individual signing MUHAMMAD ATA
PISGAH MEDICAL CLINIC CASH BALANCE PENSION PLAN AND TRUST 2012 631077810 2013-10-11 PISGAH MEDICAL CLINIC 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 2564511250
Plan sponsor’s address 6110 COUNTY ROAD 88, PISGAH, AL, 35765

Signature of

Role Plan administrator
Date 2013-10-11
Name of individual signing MUHAMMAD ATA
Role Employer/plan sponsor
Date 2013-10-11
Name of individual signing MUHAMMAD ATA
PISGAH MEDICAL CLINIC 401(K) PROFIT SHARING PLAN AND TRUST 2011 631077810 2012-09-11 PISGAH MEDICAL CLINIC 0
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 2564511250
Plan sponsor’s address 6110 COUNTY ROAD 88, PISGAH, AL, 35765

Plan administrator’s name and address

Administrator’s EIN 631077810
Plan administrator’s name PISGAH MEDICAL CLINIC
Plan administrator’s address 6110 COUNTY ROAD 88, PISGAH, AL, 35765
Administrator’s telephone number 2564511250

Signature of

Role Plan administrator
Date 2012-09-11
Name of individual signing MUHAMMAD ATA
Role Employer/plan sponsor
Date 2012-09-11
Name of individual signing MUHAMMAD ATA
PISGAH MEDICAL CLINIC CASH BALANCE PENSION PLAN AND TRUST 2011 631077810 2012-10-02 PISGAH MEDICAL CLINIC 7
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2011-01-01
Business code 621111
Sponsor’s telephone number 2564511250
Plan sponsor’s address 6110 COUNTY ROAD 88, PISGAH, AL, 35765

Plan administrator’s name and address

Administrator’s EIN 631077810
Plan administrator’s name PISGAH MEDICAL CLINIC
Plan administrator’s address 6110 COUNTY ROAD 88, PISGAH, AL, 35765
Administrator’s telephone number 2564511250

Signature of

Role Plan administrator
Date 2012-10-01
Name of individual signing MUHAMMAD ATA
Role Employer/plan sponsor
Date 2012-10-01
Name of individual signing MUHAMMAD ATA

Agent

Name Role Address
ATA, MUHAMMAD E Agent 506 HARLEY STREETSCOTTSBORO, AL 35768

Member

Name Role Address
ATA, MUHAMMAD E Member 506 HARLEY STREETSCOTTSBORO, AL 35768
MEMON, JUNAID H Member No data
AMJAD, MUHAMMAD Member 1645 SPARKMAN DR NWHUNTSVILLE, AL 35816
KHALIL, SHOAIB Member No data

Date of last update: 14 Aug 2024

Sources: Alabama Secretary of State