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Sylacauga Pediatric Clinic, LLC

Details

Name: Sylacauga Pediatric Clinic, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 29 Jan 2007 (18 years ago)
Entity Number: 000-489-492
Register Number: 000489492
County: Talladega
Place of Formation: Talladega County
Principal Address: SYLACAUGA, AL
Registered Office Street Address: 115 WEST CLAY STSYLACAUGA, AL 35150
Registered Office Street Address ZIP Code: 35150

Activities MEDICAL PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1184776551 2007-01-17 2014-09-22 115 W CLAY ST, SYLACAUGA, AL, 351503413, US 115 W CLAY ST, SYLACAUGA, AL, 351503413, US

Contacts
Phone +1 256-245-3267
Fax 2562452315

Authorized person
Name CYNTHIA DARK
Role OFFICE MANAGER
Phone 2562453267

Taxonomy
Taxonomy Code 208000000X - Pediatrics Physician
License Number 21818
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SYLACAUGA PEDIATRIC CLINIC LLC 401(K) PROFIT SHARING PLAN 2023 208101576 2024-03-08 SYLACAUGA PEDIATRIC CLINIC, LLC 29
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2562453267
Plan sponsor’s address 115 WEST CLAY STREET, SYLACAUGA, AL, 351503413
SYLACAUGA PEDIATRIC CLINIC LLC 401(K) PROFIT SHARING PLAN 2022 208101576 2023-05-23 SYLACAUGA PEDIATRIC CLINIC, LLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2562453267
Plan sponsor’s address 115 WEST CLAY STREET, SYLACAUGA, AL, 351503413
SYLACAUGA PEDIATRIC CLINIC LLC 401(K) PROFIT SHARING PLAN 2021 208101576 2022-07-15 SYLACAUGA PEDIATRIC CLINIC, LLC 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2562453267
Plan sponsor’s address 115 WEST CLAY STREET, SYLACAUGA, AL, 351503413
SYLACAUGA PEDIATRIC CLINIC LLC 401(K) PROFIT SHARING PLAN 2020 208101576 2021-07-07 SYLACAUGA PEDIATRIC CLINIC, LLC 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2562453267
Plan sponsor’s address 115 WEST CLAY STREET, SYLACAUGA, AL, 351503413
SYLACAUGA PEDIATRIC CLINIC LLC 401(K) PROFIT SHARING PLAN 2019 208101576 2020-05-27 SYLACAUGA PEDIATRIC CLINIC, LLC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2562453267
Plan sponsor’s address 115 WEST CLAY STREET, SYLACAUGA, AL, 351503413
SYLACAUGA PEDIATRIC CLINIC LLC 401(K) PROFIT SHARING PLAN 2018 208101576 2019-07-25 SYLACAUGA PEDIATRIC CLINIC, LLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2562453267
Plan sponsor’s address 115 WEST CLAY STREET, SYLACAUGA, AL, 351503413
SYLACAUGA PEDIATRIC CLINIC LLC 401(K) PROFIT SHARING PLAN 2017 208101576 2018-05-17 SYLACAUGA PEDIATRIC CLINIC, LLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2562453267
Plan sponsor’s address 115 WEST CLAY STREET, SYLACAUGA, AL, 351503413
SYLACAUGA PEDIATRIC CLINIC LLC 401(K) PROFIT SHARING PLAN 2016 208101576 2017-07-27 SYLACAUGA PEDIATRIC CLINIC, LLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2562453267
Plan sponsor’s address 115 WEST CLAY STREET, SYLACAUGA, AL, 351503413

Signature of
Role Plan administrator
Date 2017-07-27
Name of individual signing REKHA CHADALAWADA, M.D.
SYLACAUGA PEDIATRIC CLINIC LLC 401(K) PROFIT SHARING PLAN 2015 208101576 2016-07-28 SYLACAUGA PEDIATRIC CLINIC, LLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2562453267
Plan sponsor’s address 115 WEST CLAY STREET, SYLACAUGA, AL, 351503413

Signature of
Role Plan administrator
Date 2016-07-28
Name of individual signing REKHA CHADALAWADA, M.D.
SYLACAUGA PEDIATRIC CLINIC LLC 401(K) PROFIT SHARING PLAN 2014 208101576 2015-07-16 SYLACAUGA PEDIATRIC CLINIC, LLC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2562453267
Plan sponsor’s address 115 WEST CLAY STREET, SYLACAUGA, AL, 351503413

Signature of
Role Plan administrator
Date 2015-07-16
Name of individual signing REKHA CHADALAWADA, M.D.

Agent

Name Role
CHADALAWALA, REKHA Agent

Member

Name Role
CHADALAWALA, REKHA Member

Related by officers

No related officers

Related by address

SYLACAUGA, AL

Academy Van Lines, Inc. Allen Oil Company of Sylacauga, Inc. Arnold Realty and Mortgage Company, Incorporated Bama Office Supply Inc. Brown Brothers, Inc. of Sylacauga, Alabama BIAC, Inc. Central Land Company, Inc. City Tire Company of Sylacauga, Inc. Coosa Valley Insurance Agency of Sylacauga Deupree of Sylacauga, Inc.

115 WEST CLAY STSYLACAUGA, AL 35150

SYLPED, Inc. Sylacauga Pediatric Real Estate, LLC

Date of last update: 14 Aug 2024

Sources: Alabama Secretary of State

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