Watson Retina LLC

Contacts

Phone	+1 205-637-7123

Authorized person

Name	RICHARD WATSON
Role	MD
Phone	2056377123

Taxonomy

Taxonomy Code	207W00000X - Ophthalmology Physician
Is Primary	No
Taxonomy Code	207WX0107X - Retina Specialist (Ophthalmology) Physician
Is Primary	Yes
Taxonomy Code	261QM2500X - Medical Specialty Clinic/Center
Is Primary	No

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2021-01-01
Business code	621320
Sponsor’s telephone number	2052598344
Plan sponsor’s address	4505 PINE TREE CIR., STE 120, VESTAVIA, AL, 35243

Plan administrator’s name and address

Administrator’s EIN	474474775
Plan administrator’s name	GUIDELINE, INC.
Plan administrator’s address	1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number	8882283491

Signature of

Role	Plan administrator
Date	2024-05-15
Name of individual signing	QIAN LIU

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2021-01-01
Business code	621320
Sponsor’s telephone number	2052598344
Plan sponsor’s address	4505 PINE TREE CIR., STE 120, VESTAVIA, AL, 35243

Plan administrator’s name and address

Administrator’s EIN	474474775
Plan administrator’s name	GUIDELINE, INC.
Plan administrator’s address	1412 CHAPIN AVENUE, BURLINGAME, CA, 94010
Administrator’s telephone number	8882283491

Signature of

Role	Plan administrator
Date	2023-05-27
Name of individual signing	CHRISTINE RIMER

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2021-01-01
Business code	621320
Sponsor’s telephone number	2052598344
Plan sponsor’s address	4505 PINE TREE CIR., STE 120, VESTAVIA, AL, 35243

Plan administrator’s name and address

Administrator’s EIN	474474775
Plan administrator’s name	GUIDELINE, INC.
Plan administrator’s address	1645 E 6TH STREET, SUITE 200, AUSTIN, TX, 78702
Administrator’s telephone number	8882283491

Signature of

Role	Plan administrator
Date	2022-05-19
Name of individual signing	CHRISTINE RIMER