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East Montgomery Pediatrics, LLC

Details

Name: East Montgomery Pediatrics, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 31 Jul 2007 (17 years ago)
Entity Number: 000-498-097
Register Number: 000498097
County: Montgomery
Place of Formation: Montgomery County
Principal Address: MONTGOMERY, AL
Registered Office Street Address: 316 ST LUKES DRMONTGOMERY, AL 36117
Registered Office Street Address ZIP Code: 36117

Activities PROVIDE MEDICAL SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1952945602 2019-11-05 2019-11-05 337 ST LUKES DRIVE, MONTGOMERY, AL, 36117, US 337 ST LUKES DRIVE, MONTGOMERY, AL, 36117, US

Contacts
Phone +1 334-356-1411
Fax 3343561578

Authorized person
Name AINA ROQUE
Role OFFICE MANAGER
Phone 3343561411

Taxonomy
Taxonomy Code 208000000X - Pediatrics Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EAST MONTGOMERY PEDIATRICS, LLC 401(K) PLAN 2022 392055922 2023-10-16 EAST MONTGOMERY PEDIATRICS, 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 3343561411
Plan sponsor’s address 337 ST. LUKES DRIVE, MONTGOMERY, AL, 361177102

Plan administrator’s name and address
Administrator’s EIN 392055922
Plan administrator’s name EAST MONTGOMERY PEDIATRICS, LLC
Plan administrator’s address 337 ST. LUKES DRIVE, MONTGOMERY, AL, 361177102
Administrator’s telephone number 3343561411
EAST MONTGOMERY PEDIATRICS, LLC 401(K) PLAN 2021 392055922 2022-10-15 EAST MONTGOMERY PEDIATRICS, 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 3343561411
Plan sponsor’s address 337 ST. LUKES DRIVE, MONTGOMERY, AL, 361177102

Plan administrator’s name and address
Administrator’s EIN 392055922
Plan administrator’s name EAST MONTGOMERY PEDIATRICS, LLC
Plan administrator’s address 337 ST. LUKES DRIVE, MONTGOMERY, AL, 361177102
Administrator’s telephone number 3343561411
EAST MONTGOMERY PEDIATRICS, LLC 401(K) PLAN 2020 392055922 2021-10-12 EAST MONTGOMERY PEDIATRICS, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3343561411
Plan sponsor’s address 337 ST. LUKES DRIVE, MONTGOMERY, AL, 361177102

Plan administrator’s name and address
Administrator’s EIN 392055922
Plan administrator’s name EAST MONTGOMERY PEDIATRICS, LLC
Plan administrator’s address 337 ST. LUKES DRIVE, MONTGOMERY, AL, 361177102
Administrator’s telephone number 3343561411
EAST MONTGOMERY PEDIATRICS, LLC 401(K) PLAN 2019 392055922 2020-10-05 EAST MONTGOMERY PEDIATRICS, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3343561411
Plan sponsor’s address 337 ST. LUKES DRIVE, MONTGOMERY, AL, 361177102

Plan administrator’s name and address
Administrator’s EIN 392055922
Plan administrator’s name EAST MONTGOMERY PEDIATRICS, LLC
Plan administrator’s address 337 ST. LUKES DRIVE, MONTGOMERY, AL, 361177102
Administrator’s telephone number 3343561411
EAST MONTGOMERY PEDIATRICS, LLC 401(K) PLAN 2018 392055922 2019-07-29 EAST MONTGOMERY PEDIATRICS, 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 3343561411
Plan sponsor’s address 337 ST. LUKES DRIVE, MONTGOMERY, AL, 361177102

Plan administrator’s name and address
Administrator’s EIN 392055922
Plan administrator’s name EAST MONTGOMERY PEDIATRICS, LLC
Plan administrator’s address 337 ST. LUKES DRIVE, MONTGOMERY, AL, 361177102
Administrator’s telephone number 3343561411
EAST MONTGOMERY PEDIATRICS, LLC 401(K) PLAN 2017 392055922 2018-07-30 EAST MONTGOMERY PEDIATRICS, 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 3343561411
Plan sponsor’s address 337 ST. LUKES DRIVE, MONTGOMERY, AL, 361177102

Plan administrator’s name and address
Administrator’s EIN 392055922
Plan administrator’s name EAST MONTGOMERY PEDIATRICS, LLC
Plan administrator’s address 337 ST. LUKES DRIVE, MONTGOMERY, AL, 361177102
Administrator’s telephone number 3343561411
EAST MONTGOMERY PEDIATRICS, LLC 401(K) PLAN 2016 392055922 2017-10-13 EAST MONTGOMERY PEDIATRICS, 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 3343561411
Plan sponsor’s address 337 ST. LUKES DRIVE, MONTGOMERY, AL, 361177102

Plan administrator’s name and address
Administrator’s EIN 392055922
Plan administrator’s name EAST MONTGOMERY PEDIATRICS, LLC
Plan administrator’s address 337 ST. LUKES DRIVE, MONTGOMERY, AL, 361177102
Administrator’s telephone number 3343561411
EAST MONTGOMERY PEDIATRICS, LLC 401(K) PLAN 2015 392055922 2016-10-16 EAST MONTGOMERY PEDIATRICS, 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 3343561411
Plan sponsor’s address 337 ST. LUKES DRIVE, MONTGOMERY, AL, 361177102

Plan administrator’s name and address
Administrator’s EIN 392055922
Plan administrator’s name EAST MONTGOMERY PEDIATRICS, LLC
Plan administrator’s address 337 ST. LUKES DRIVE, MONTGOMERY, AL, 361177102
Administrator’s telephone number 3343561411
EAST MONTGOMERY PEDIATRICS, LLC 401(K) PLAN 2014 392055922 2015-10-14 EAST MONTGOMERY PEDIATRICS, 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 3343561411
Plan sponsor’s address 337 ST. LUKES DRIVE, MONTGOMERY, AL, 361177102

Plan administrator’s name and address
Administrator’s EIN 392055922
Plan administrator’s name EAST MONTGOMERY PEDIATRICS, LLC
Plan administrator’s address 337 ST. LUKES DRIVE, MONTGOMERY, AL, 361177102
Administrator’s telephone number 3343561411

Signature of
Role Plan administrator
Date 2015-10-14
Name of individual signing DR. ELMER ROQUE
EAST MONTGOMERY PEDIATRICS, LLC 401(K) PLAN 2013 392055922 2014-10-06 EAST MONTGOMERY PEDIATRICS, LLC 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-01-01
Business code 621111
Sponsor’s telephone number 3343561411
Plan sponsor’s address 337 ST. LUKES DRIVE, MONTGOMERY, AL, 361177102

Plan administrator’s name and address
Administrator’s EIN 392055922
Plan administrator’s name EAST MONTGOMERY PEDIATRICS, LLC
Plan administrator’s address 337 ST. LUKES DRIVE, MONTGOMERY, AL, 361177102
Administrator’s telephone number 3343561411

Signature of
Role Plan administrator
Date 2014-10-06
Name of individual signing DR. ELMER ROQUE

Member

Name Role Address
ROQUE, ELMER J Member 406 ARROWLEAF COURTMONTGOMERY, AL 36117
ROQUE, AINA Member No data

Agent

Name Role Address
ROQUE, ELMER J Agent 406 ARROWLEAF COURTMONTGOMERY, AL 36117

Related by officers

ROQUE, ELMER J

Seashore Properties, LLC RMR Properties, LLC

ROQUE, AINA

RMR Properties, LLC

Related by address

MONTGOMERY, AL

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316 ST LUKES DRMONTGOMERY, AL 36117

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Date of last update: 14 Aug 2024

Sources: Alabama Secretary of State

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