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Moonlight Diagnostics, LLC

Details

Name: Moonlight Diagnostics, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 23 Jan 2019 (6 years ago)
Entity Number: 000-540-325
Register Number: 000540325
County: Montgomery
Place of Formation: Montgomery County
Registered Office Street Address: 2 North Jackson Street, Suite 605Montgomery, AL 36117
Registered Office Street Address ZIP Code: 36117

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1801351291 2019-02-10 2019-06-03 3188 PARLIAMENT CIR STE 802, MONTGOMERY, AL, 361167271, US 3188 PARLIAMENT CIR STE 802, MONTGOMERY, AL, 361167271, US

Contacts
Phone +1 334-416-8298
Fax 8332604473

Authorized person
Name GREGORY R LIPSCOMB
Role PRESIDENT
Phone 2515547798

Taxonomy
Taxonomy Code 2084N0400X - Neurology Physician
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MOONLIGHT DIAGNOSTICS, LLC 401(K) PROFIT SHARING PLAN 2023 833261117 2024-07-15 MOONLIGHT DIAGNOSTICS, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 3344168298
Plan sponsor’s address 3188 PARLIAMENT CIRCLE, SUITE 802, MONTGOMERY, AL, 36116
MOONLIGHT DIAGNOSTICS, LLC 401(K) PROFIT SHARING PLAN 2022 833261117 2023-06-14 MOONLIGHT DIAGNOSTICS, LLC 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 3344168298
Plan sponsor’s address 3188 PARLIAMENT CIRCLE, SUITE 802, MONTGOMERY, AL, 36116
MOONLIGHT DIAGNOSTICS, LLC 401(K) PROFIT SHARING PLAN 2021 833261117 2022-04-11 MOONLIGHT DIAGNOSTICS, LLC 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 3344168298
Plan sponsor’s address 3188 PARLIAMENT CIRCLE, SUITE 802, MONTGOMERY, AL, 36116
MOONLIGHT DIAGNOSTICS, LLC HEALTH AND WELFARE BENEFIT PLAN 2020 833261117 2021-10-09 MOONLIGHT DIAGNOSTICS, LLC 3
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2019-04-01
Business code 524140
Sponsor’s telephone number 3344168298
Plan sponsor’s address 3188 PARLIAMENT CIRCLE, SUITE 802, MONTGOMERY, AL, 36116

Plan administrator’s name and address
Administrator’s EIN 834125247
Plan administrator’s name ARSENAL HEALTH LLC
Plan administrator’s address 5151 HAMPSTEAD HIGH STREET STE 200, MONTGOMERY, AL, 36116
Administrator’s telephone number 3342607774

Signature of
Role Plan administrator
Date 2021-10-06
Name of individual signing THOMAS BRITT TAYLOR
MOONLIGHT DIAGNOSTICS, LLC 401(K) PROFIT SHARING PLAN 2020 833261117 2021-05-04 MOONLIGHT DIAGNOSTICS, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 3344168298
Plan sponsor’s address 3188 PARLIAMENT CIRCLE, SUITE 802, MONTGOMERY, AL, 36116
MOONLIGHT DIAGNOSTICS, LLC HEALTH AND WELFARE 2019 833261117 2020-10-14 MOONLIGHT DIAGNOSTICS, LLC 3
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2019-04-01
Business code 524140
Sponsor’s telephone number 3344168298
Plan sponsor’s address 3188 PARLIAMENT CIRCLE, SUITE 802, MONTGOMERY, AL, 36116

Plan administrator’s name and address
Administrator’s EIN 834125247
Plan administrator’s name ARSENAL HEALTH LLC
Plan administrator’s address 5151 HAMPSTEAD HIGH STREET STE 200, MONTGOMERY, AL, 36116
Administrator’s telephone number 3342607774

Signature of
Role Plan administrator
Date 2020-10-14
Name of individual signing THOMAS BRITT TAYLOR

Agent

Name Role
C T Corporation System Agent

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Related by address

2 North Jackson Street, Suite 605Montgomery, AL 36117

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Date of last update: 14 Aug 2024

Sources: Alabama Secretary of State

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