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GHORI, LLC

Details

Name: GHORI, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 29 Sep 2005 (19 years ago) (Companies founded in September 2005)
Entity Number: 000-469-538
Register Number: 000469538
ZIP code: 36303 (Companies in Houston, 36303)
County: Houston
Place of Formation: Houston County
Principal Address: DOTHAN, AL
Registered Office Street Address: 508 RIVEREDGE PARKWAYDOTHAN, AL 36303

Activities MEDICAL PRACTICE

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
MNVSWPXQG6R3 2025-04-17 1369 W MAIN ST, DOTHAN, AL, 36301, 1309, USA 1369 W MAIN ST, SUITE 2, DOTHAN, AL, 36301, 1309, USA

Business Information

Congressional District 02
State/Country of Incorporation AL, USA
Activation Date 2024-04-19
Initial Registration Date 2023-06-21
Entity Start Date 2005-11-04
Fiscal Year End Close Date Dec 31

Points of Contacts

Electronic Business
Title PRIMARY POC
Name STEFANIE N PERKINS
Role OFFICE MANAGER
Address 1369 W MAIN ST, SUITE 2, DOTHAN, AL, 36301, 1309, USA
Government Business
Title PRIMARY POC
Name STEFANIE N PERKINS
Role OFFICE MANAGER
Address 1369 W MAIN ST, SUITE 2, DOTHAN, AL, 36301, 1309, USA
Past Performance Information not Available

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1144402629 2007-11-27 2022-10-21 1369 W. MAIN ST., SUITE 2, DOTHAN, AL, 36301, US 1369 W. MAIN ST., SUITE 2, DOTHAN, AL, 36301, US

Contacts

Phone +1 334-792-8679
Fax 8773614549

Authorized person

Name DR. SHER M GHORI
Role OWNER
Phone 3347928679

Taxonomy

Taxonomy Code 174400000X - Specialist
License Number 00023730
State AL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 529926690
State AL
Issuer MEDICAID
Number 00051530943
State AL
Issuer BCBS PROV NUMBER
Number 51530943

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
WIREGRASS NEUROLOGY RETIREMENT PLAN 2023 203552467 2024-10-14 GHORI, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3347928679
Plan sponsor’s address 1369 W. MAIN STREET, SUITE #2, DOTHAN, AL, 36301
WIREGRASS NEUROLOGY RETIREMENT PLAN 2022 203552467 2023-10-09 GHORI, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3347928679
Plan sponsor’s address 1369 W. MAIN STREET, SUITE #2, DOTHAN, AL, 36301
WIREGRASS NEUROLOGY RETIREMENT PLAN 2021 203552467 2022-10-15 GHORI, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3347928679
Plan sponsor’s address 1369 W. MAIN STREET, SUITE #2, DOTHAN, AL, 36301
WIREGRASS NEUROLOGY RETIREMENT PLAN 2020 203552467 2021-10-13 GHORI, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3347928679
Plan sponsor’s address 1118 ROSS CLARK CIRCLE SUITE 301, DOTHAN, AL, 36301
WIREGRASS NEUROLOGY RETIREMENT PLAN 2019 203552467 2020-10-15 GHORI, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3347928679
Plan sponsor’s address 1118 ROSS CLARK CIRCLE SUITE 301, DOTHAN, AL, 36301
WIREGRASS NEUROLOGY RETIREMENT PLAN 2018 203552467 2019-10-14 GHORI, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3347928679
Plan sponsor’s address 1118 ROSS CLARK CIRCLE SUITE 301, DOTHAN, AL, 36301
WIREGRASS NEUROLOGY RETIREMENT PLAN 2017 203552467 2018-10-03 GHORI, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3347928679
Plan sponsor’s address 1118 ROSS CLARK CIRCLE SUITE 301, DOTHAN, AL, 36301
WIREGRASS NEUROLOGY RETIREMENT PLAN 2016 203552467 2017-10-12 GHORI, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3347928679
Plan sponsor’s address 1118 ROSS CLARK CIRCLE SUITE 301, DOTHAN, AL, 36301
WIREGRASS NEUROLOGY RETIREMENT PLAN 2015 203552467 2016-10-13 GHORI, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3347928679
Plan sponsor’s address 1118 ROSS CLARK CIRCLE SUITE 301, DOTHAN, AL, 36301
WIREGRASS NEUROLOGY RETIREMENT PLAN 2014 203552467 2015-07-30 GHORI, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3347928679
Plan sponsor’s address 1118 ROSS CLARK CIRCLE SUITE 301, DOTHAN, AL, 36301

Signature of

Role Plan administrator
Date 2015-07-30
Name of individual signing SHER M. GHORI, M.D.

Agent

Name Role
GHORI, SHER MOHAMMAD Agent

Member

Name Role
GHORI, SHER MOHAMMAD Member

Date of last update: 14 Aug 2024

Sources: Alabama Secretary of State