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Gardendale Surgical Associates, LLC

Details

Name: Gardendale Surgical Associates, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 20 Nov 2006 (18 years ago)
Entity Number: 000-486-904
Register Number: 000486904
County: Montgomery
Place of Formation: Jefferson County
Principal Address: 1445 ROSS AVENUE SUITE 1400DALLAS, TX 75202
Registered Office Street Address: 2 NORTH JACKSON STREET SUITE 605MONTGOMERY, AL 36104
Registered Office Street Address ZIP Code: 36104

Activities AMBULATORY SURGERY CENTER

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1235541418 2014-05-22 2014-05-22 PO BOX 235022, MONTGOMERY, AL, 361235022, US 2213 DECATUR HWY, GARDENDALE, AL, 350712301, US

Contacts
Phone +1 334-386-2051
Fax 3344811200
Phone +1 205-418-6021

Authorized person
Name DEIRDRE ODOM
Role MANAGER
Phone 3343966930

Taxonomy
Taxonomy Code 207L00000X - Anesthesiology Physician
Is Primary Yes

Central Index Key

CIK number Mailing Address Business Address Phone
1480321 1 CHASE CORPORATE DRIVE, SUITE 200, BIRMINGHAM, AL, 35244 1 CHASE CORPORATE DRIVE, SUITE 200, BIRMINGHAM, AL, 35244 205-824-6250

Filings since 2010-01-15
Form type D
File number 021-137888
Filing date 2010-01-15
File View File

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
GARDENDALE SURGICAL ASSOCIATES 401 K PROFIT SHARING PLAN TRUST 2017 205936644 2018-07-22 GARDENDALE SURGICAL ASSOCIATES 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2058246250
Plan sponsor’s address 1 CHASE CORPORATE DR STE 200, BIRMINGHAM, AL, 352447060

Signature of
Role Plan administrator
Date 2018-07-22
Name of individual signing J. MARK EDWARDS
GARDENDALE SURGICAL ASSOCIATES 401 K PROFIT SHARING PLAN TRUST 2016 205936644 2017-06-20 GARDENDALE SURGICAL ASSOCIATES 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2058246250
Plan sponsor’s address 1 CHASE CORPORATE DR STE 200, BIRMINGHAM, AL, 352447060

Signature of
Role Plan administrator
Date 2017-06-20
Name of individual signing MARK EDWARDS
GARDENDALE SURGICAL ASSOCIATES 401 K PROFIT SHARING PLAN TRUST 2015 205936644 2016-07-14 GARDENDALE SURGICAL ASSOCIATES 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2058246250
Plan sponsor’s address 1 CHASE CORPORATE DR STE 200, BIRMINGHAM, AL, 352447060

Signature of
Role Plan administrator
Date 2016-07-14
Name of individual signing J. MARK EDWARDS
GARDENDALE SURGICAL ASSOCIATES 401 K PROFIT SHARING PLAN TRUST 2014 205936644 2015-07-28 GARDENDALE SURGICAL ASSOCIATES 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2058246250
Plan sponsor’s address 1 CHASE CORPORATE DR STE 200, BIRMINGHAM, AL, 352447060

Signature of
Role Plan administrator
Date 2015-07-28
Name of individual signing MARK EDWARDS
GARDENDALE SURGICAL ASSOCIATES 401 K PROFIT SHARING PLAN TRUST 2013 205936644 2014-07-24 GARDENDALE SURGICAL ASSOCIATES 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2058246250
Plan sponsor’s address 1 CHASE CORPORATE DR STE 200, BIRMINGHAM, AL, 352447060

Signature of
Role Plan administrator
Date 2014-07-24
Name of individual signing MARK EDWARDS
GARDENDALE SURGICAL ASSOCIATES 401 K PROFIT SHARING PLAN TRUST 2012 205936644 2013-07-26 GARDENDALE SURGICAL ASSOCIATES 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2058246250
Plan sponsor’s address 1 CHASE CORPORATE DR STE 200, BIRMINGHAM, AL, 352447060

Signature of
Role Plan administrator
Date 2013-07-26
Name of individual signing GARDENDALE SURGICAL ASSOCIATES
GARDENDALE SURGICAL ASSOCIATES 401 K PROFIT SHARING PLAN TRUST 2011 205936644 2012-07-12 GARDENDALE SURGICAL ASSOCIATES 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2058246250
Plan sponsor’s address 1 CHASE CORPORATE DR STE 200, BIRMINGHAM, AL, 352447060

Plan administrator’s name and address
Administrator’s EIN 205936644
Plan administrator’s name GARDENDALE SURGICAL ASSOCIATES
Plan administrator’s address 1 CHASE CORPORATE DR STE 200, BIRMINGHAM, AL, 352447060
Administrator’s telephone number 2058246250

Signature of
Role Plan administrator
Date 2012-07-12
Name of individual signing GARDENDALE SURGICAL ASSOCIATES
GARDENDALE SURGICAL ASSOCIATES 401 K PROFIT SHARING PLAN TRUST 2010 205936644 2011-06-14 GARDENDALE SURGICAL ASSOCIATES 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2058246250
Plan sponsor’s address 1 CHASE CORPORATE DR STE 200, BIRMINGHAM, AL, 35244

Plan administrator’s name and address
Administrator’s EIN 205936644
Plan administrator’s name GARDENDALE SURGICAL ASSOCIATES
Plan administrator’s address 1 CHASE CORPORATE DR STE 200, BIRMINGHAM, AL, 35244
Administrator’s telephone number 2058246250

Signature of
Role Plan administrator
Date 2011-06-14
Name of individual signing GARDENDALE SURGICAL ASSOCIATES

Agent

Name Role Address
CT CORPORATION SYSTEM Agent 6190 POWERS FERRY RD STE 600ATLANTA, GA 30339

Member

Name Role Address
BROOKWOOD BAPTIST HEALTH 2 LLC Member 1445 ROSS AVENUE SUITE 1400DALLAS, TX 75202

Organizer

Name Role
BROOKWOOD CENTER DEVELOPMENT CORPORATION Organizer

Related by officers

CT CORPORATION SYSTEM

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Related by address

1445 ROSS AVENUE SUITE 1400DALLAS, TX 75202

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2 NORTH JACKSON STREET SUITE 605MONTGOMERY, AL 36104

Sonic Drive In of Russellville, Inc. First Alabama Title, Inc. RedPrairie Corporation RedPrairie Services Corporation Mercy Life of Alabama Maxair Mechanical, LLC LEAF Capital Funding, LLC West Roofing Systems, Inc. Avenue C, LLC Stetson - Beemer & Co.

Date of last update: 14 Aug 2024

Sources: Alabama Secretary of State

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