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Ashland Family Practice LLC

Details

Name: Ashland Family Practice LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 17 Mar 2006 (19 years ago) (Companies founded in March 2006)
Entity Number: 000-476-372
Register Number: 000476372
Place of Formation: Clay County
Principal Address: LINEVILLE, AL
Registered Office Street Address: 2370 TALLADEGA STLINEVILLE, AL 36226

Activities MEDICAL PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1902835655 2006-07-02 2024-02-12 PO BOX 67, ASHLAND, AL, 362510067, US 83745 HIGHWAY 9, ASHLAND, AL, 36251, US

Contacts
Phone +1 256-354-4139
Fax 2563544137

Authorized person
Name DR. CHARLES DAVID HENSLEIGH
Role PHYSICIAN/OWNER
Phone 2563544139

Taxonomy
Taxonomy Code 207Q00000X - Family Medicine Physician
License Number 9297
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ASHLAND FAMILY PRACTICE, LLC 401(K) PROFIT SHARING PLAN 2023 204531768 2024-10-03 ASHLAND FAMILY PRACTICE, LLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-01
Business code 621111
Sponsor’s telephone number 2563544139
Plan sponsor’s address P.O. BOX 67, ASHLAND, AL, 36251

Signature of
Role Plan administrator
Date 2024-10-03
Name of individual signing CHARLES HENSLEIGH
Valid signature Filed with authorized/valid electronic signature
ASHLAND FAMILY PRACTICE, LLC 401(K) PROFIT SHARING PLAN 2022 204531768 2023-07-27 ASHLAND FAMILY PRACTICE, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-01
Business code 621111
Sponsor’s telephone number 2563544139
Plan sponsor’s address P.O. BOX 67, ASHLAND, AL, 36251

Signature of
Role Plan administrator
Date 2023-07-27
Name of individual signing CHARLES HENSLEIGH
ASHLAND FAMILY PRACTICE, LLC 401(K) PROFIT SHARING PLAN 2021 204531768 2022-09-20 ASHLAND FAMILY PRACTICE, LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-01
Business code 621111
Sponsor’s telephone number 2563544139
Plan sponsor’s address P.O. BOX 67, ASHLAND, AL, 36251

Signature of
Role Plan administrator
Date 2022-09-20
Name of individual signing CHARLES HENSLEIGH
ASHLAND FAMILY PRACTICE, LLC 401(K) PROFIT SHARING PLAN 2020 204531768 2021-07-28 ASHLAND FAMILY PRACTICE, LLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-01
Business code 621111
Sponsor’s telephone number 2563544139
Plan sponsor’s address P.O. BOX 67, ASHLAND, AL, 36251

Signature of
Role Plan administrator
Date 2021-07-28
Name of individual signing CHARLES HENSLEIGH
ASHLAND FAMILY PRACTICE, LLC 401(K) PROFIT SHARING PLAN 2019 204531768 2020-07-28 ASHLAND FAMILY PRACTICE, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-01
Business code 621111
Sponsor’s telephone number 2563544139
Plan sponsor’s address P.O. BOX 67, ASHLAND, AL, 36251

Signature of
Role Plan administrator
Date 2020-07-28
Name of individual signing CHARLES HENSLEIGH
ASHLAND FAMILY PRACTICE, LLC 401(K) PROFIT SHARING PLAN 2018 204531768 2019-06-24 ASHLAND FAMILY PRACTICE, LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-01
Business code 621111
Sponsor’s telephone number 2563544139
Plan sponsor’s address P.O. BOX 67, ASHLAND, AL, 36251

Signature of
Role Plan administrator
Date 2019-06-24
Name of individual signing CHARLES HENSLEIGH
ASHLAND FAMILY PRACTICE, LLC 401(K) PROFIT SHARING PLAN 2017 204531768 2018-07-17 ASHLAND FAMILY PRACTICE, LLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-01
Business code 621111
Sponsor’s telephone number 2563544139
Plan sponsor’s address P.O. BOX 67, ASHLAND, AL, 36251

Signature of
Role Plan administrator
Date 2018-07-17
Name of individual signing CHARLES HENSLEIGH
ASHLAND FAMILY PRACTICE, LLC 401(K) PROFIT SHARING PLAN 2016 204531768 2017-07-31 ASHLAND FAMILY PRACTICE, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-01
Business code 621111
Sponsor’s telephone number 2563544139
Plan sponsor’s address 83745 HIGHWAY 9, ASHLAND, AL, 362517988

Signature of
Role Plan administrator
Date 2017-07-31
Name of individual signing CHARLES HENSLEIGH
ASHLAND FAMILY PRACTICE, LLC 401(K) PROFIT SHARING PLAN 2015 204531768 2016-10-14 ASHLAND FAMILY PRACTICE, LLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-01
Business code 621111
Sponsor’s telephone number 2563544139
Plan sponsor’s address 83745 HIGHWAY 9, ASHLAND, AL, 362517988

Signature of
Role Plan administrator
Date 2016-10-14
Name of individual signing CHARLES HENSLEIGH
ASHLAND FAMILY PRACTICE, LLC 401(K) PROFIT SHARING PLAN 2014 204531768 2015-06-29 ASHLAND FAMILY PRACTICE, LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-01
Business code 621111
Sponsor’s telephone number 2563544139
Plan sponsor’s address 83745 HIGHWAY 9, ASHLAND, AL, 36251

Signature of
Role Plan administrator
Date 2015-06-29
Name of individual signing CHARLES HENSLEIGH

Agent

Name Role
HENSLEIGH, CHARLES DAVID Agent

Member

Name Role
HENSLEIGH, CHARLES DAVID Member

Related by officers

No related officers

Related by address

LINEVILLE, AL

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Date of last update: 14 Aug 2024

Sources: Alabama Secretary of State

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