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Surgical Specialists Group, LLC

Details

Name: Surgical Specialists Group, LLC
Jurisdiction: Alabama
Legal type: Foreign Limited Liability Company
Status: Withdrawn
Date of registration: 07 Jul 2004 (20 years ago) (Companies founded in July 2004)
Entity Number: 000-606-985
Register Number: 000606985
ZIP code: 35502 (Companies in Walker, 35502)
County: Walker
Place of Formation: Delaware
Principal Address: 2950 HWY 78 EJASPER, AL 35502
Registered Office Street Address: 2950 HWY 78 EASTJASPER, AL 35502

Activities TO OWN AND OPERATE AN OUTPATIENT SURGERY CENTER

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1043367196 2007-01-04 2009-08-18 1323 SUMMIT DRIVE, JASPER, AL, 355010114, US 1323 SUMMIT DRIVE, JASPER, AL, 355010114, US

Contacts

Phone +1 205-221-1324
Fax 2052211325

Authorized person

Name MR. GARY ELLIS
Role ADMINISTRATOR
Phone 2052211324

Taxonomy

Taxonomy Code 261QA1903X - Ambulatory Surgical Clinic/Center
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SURGICAL SPECIALISTS GROUP, LLC 401(K) PLAN 2010 201398879 2011-09-19 SURGICAL SPECIALISTS GROUP, LLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2052211324
Plan sponsor’s address 1323 SUMMITT, JASPER, AL, 355010114

Plan administrator’s name and address

Administrator’s EIN 201398879
Plan administrator’s name SURGICAL SPECIALISTS GROUP, LLC
Plan administrator’s address 1323 SUMMITT, JASPER, AL, 355010114
Administrator’s telephone number 2052211324

Signature of

Role Plan administrator
Date 2011-09-19
Name of individual signing SHERRIE PIKE
Role Employer/plan sponsor
Date 2011-09-19
Name of individual signing SHERRIE PIKE
SURGICAL SPECIALISTS GROUP, LLC 401(K) PLAN 2009 201398879 2010-10-12 SURGICAL SPECIALISTS GROUP, LLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2052211324
Plan sponsor’s address 1323 SUMMITT, JASPER, AL, 355010114

Plan administrator’s name and address

Administrator’s EIN 201398879
Plan administrator’s name SURGICAL SPECIALISTS GROUP, LLC
Plan administrator’s address 1323 SUMMITT, JASPER, AL, 355010114
Administrator’s telephone number 2052211324

Signature of

Role Plan administrator
Date 2010-10-12
Name of individual signing SHERRIE T PIKE
Role Employer/plan sponsor
Date 2010-10-12
Name of individual signing SHERRIE T PIKE

Agent

Name Role
VAGUE, KENDALL C M.D Agent

Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State