| Name: | Cedar Street Primary Care, Inc. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 08 Aug 2018 (6 years ago) |
| Entity Number: | 000-526-862 |
| Register Number: | 000526862 |
| County: | Morgan |
| Place of Formation: | Morgan County |
| Principal Address: | 200 CEDAR STREET NWHARTSELLE, AL 35640 |
| Principal Address ZIP Code: | 35640 |
| Registered Office Street Address: | 220 CEDAR STREET NWHARTSELLE, AL 35640 |
| Registered Office Street Address ZIP Code: | 35640 |
| Authorized Capital: | 1,000 @ $1/PV |
Activities
PRIMARY CAR CLINIC
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912486937 | 2018-08-09 | 2023-09-06 | 214 HIGHWAY 31 NW, HARTSELLE, AL, 356404445, US | 220 CEDAR ST NW, HARTSELLE, AL, 35640, US | |||||||||||||||||||||
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| Phone | +1 256-292-7410 |
| Fax | 2565029879 |
| Phone | +1 256-773-2260 |
Authorized person
| Name | JEB STUART HORNSBY |
| Role | PRESIDENT |
| Phone | 2562927410 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 29015 |
| State | AL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CEDAR STREET PRIMARY CARE, INC. 401(K) PLAN | 2022 | 831424365 | 2023-04-17 | CEDAR STREET PRIMARY CARE, INC. | 10 | |||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2023-04-15 |
| Name of individual signing | JEB HORNSBY |
| Role | Employer/plan sponsor |
| Date | 2023-04-15 |
| Name of individual signing | JEB HORNSBY |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2567732660 |
| Plan sponsor’s address | 220 CEDAR ST., N.W., HARTSELLE, AL, 35640 |
Signature of
| Role | Plan administrator |
| Date | 2022-04-14 |
| Name of individual signing | JEB HORNSBY |
| Role | Employer/plan sponsor |
| Date | 2022-04-14 |
| Name of individual signing | JEB HORNSBY |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2567732660 |
| Plan sponsor’s address | 220 CEDAR ST., N.W., HARTSELLE, AL, 35640 |
Signature of
| Role | Plan administrator |
| Date | 2021-04-06 |
| Name of individual signing | JEB HORNSBY |
| Role | Employer/plan sponsor |
| Date | 2021-04-06 |
| Name of individual signing | JEB HORNSBY |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2567732660 |
| Plan sponsor’s address | 220 CEDAR ST., N.W., HARTSELLE, AL, 35640 |
Signature of
| Role | Plan administrator |
| Date | 2020-08-19 |
| Name of individual signing | JEB HORNSBY |
| Role | Employer/plan sponsor |
| Date | 2020-08-19 |
| Name of individual signing | JEB HORNSBY |
| Name | Role | Address |
|---|---|---|
| HENRY, LORI | Agent | 400 SPARKMAN STREETHARTSELLE, AL 35640 |
| Name | Role | Address |
|---|---|---|
| HENRY, LORI | Director | 400 SPARKMAN STREETHARTSELLE, AL 35640 |
| HORNSBY, JEB | Director | 1821 OXFORD DRIVE N.W.CULLMAN, AL 35057 |
| Name | Role | Address |
|---|---|---|
| WILLOUGHBY, ANTHONY C | Incorporator | P.O. BOX 1387BIRMINGHAM, AL 35201 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
