| Name: | Physicians Care of Clarke |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Non-Profit Corporation |
| Status: | Exists |
| Date of registration: | 20 Nov 2018 (6 years ago) (Companies founded in November 2018) |
| Entity Number: | 000-535-518 |
| Register Number: | 000535518 |
| ZIP code: | 36784 (Companies in Clarke, 36784) |
| County: | Clarke |
| Place of Formation: | Clarke County |
| Principal Address: | 1145 TREVOR CIRCLETHOMASVILLE, AL 36784 |
| Registered Office Street Address: | 24B CAMDEN BYPCAMDEN, AL 36726 |
Activities
PROVIDE HEALTHCARE SERVICES
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EYJJXGP1MW64 | 2025-03-25 | 24B CAMDEN BYP, CAMDEN, AL, 36726, 1770, USA | 24B CAMDEN BYP, CAMDEN, AL, 36726, 1770, USA | |||||||||||||||||||||||||||||||||||||||
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| Doing Business As | PHYSICIANS CARE OF CLARKE |
| URL | physicianscare.org |
| Congressional District | 07 |
| State/Country of Incorporation | AL, USA |
| Activation Date | 2024-03-27 |
| Initial Registration Date | 2020-04-30 |
| Entity Start Date | 2018-11-20 |
| Fiscal Year End Close Date | Dec 31 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | FARRELL TURNER |
| Address | 24B CAMDEN BYP, CAMDEN, AL, 36726, 1770, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | FARRELL TURNER |
| Address | 24B CAMDEN BYP, CAMDEN, AL, 36726, 1770, USA |
| Past Performance | Information not Available |
|---|
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1801502265 | 2023-01-27 | 2023-06-01 | 24B CAMDEN BYP, CAMDEN, AL, 367261770, US | 315 E PUSHMATAHA ST, BUTLER, AL, 369042533, US | |||||||||||||||||
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| Phone | +1 334-882-1919 |
| Phone | +1 205-278-4315 |
| Fax | 2052784348 |
Authorized person
| Name | FARRELL A TURNER |
| Role | CEO |
| Phone | 2562010095 |
Taxonomy
| Taxonomy Code | 261QF0400X - Federally Qualified Health Center (FQHC) |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PHYSICIANS CARE OF CLARKE | 2022 | 272806868 | 2023-10-13 | PHYSICIANS CARE OF CLARKE | 0 | |||||||||||||||||||||||||||||
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| Administrator’s EIN | 630926271 |
| Plan administrator’s name | BENETECH ADMINISTRATORS, INC. |
| Plan administrator’s address | P.O. BOX 530967, BIRMINGHAM, AL, 35253 |
| Administrator’s telephone number | 2058792824 |
Signature of
| Role | Plan administrator |
| Date | 2023-10-13 |
| Name of individual signing | ALAN SPAIN |
| Name | Role | Address |
|---|---|---|
| ZIEBACH, ANNA | Director | 442 HIDDEN CREEK LANEGROVE HILL, AL 36460 |
| KIDD, HUEY R | Director | 1145 TREVOR CIRCLETHOMASVILLE, AL 36784 |
| PHILLIPPI, WYLYNN | Director | 116 COURT STGROVE HILL, AL 36451 |
| TURNER, FARRELL | Director | 1945 HIDDEN CREEK LANEGROVE HILL, AL 36451 |
| Name | Role | Address |
|---|---|---|
| KIDD, HUEY R | Agent | 1145 TREVOR CIRCLETHOMASVILLE, AL 36784 |
Date of last update: 14 Aug 2024
Sources: Alabama Secretary of State
