| Name: | Medical Data Solutions, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Dissolved |
| Date of registration: | 16 Jan 1998 (27 years ago) (Companies founded in January 1998) |
| Date of dissolution: | 20 Dec 2019 |
| Entity Number: | 000-658-671 |
| Register Number: | 000658671 |
| Historical Names: |
Physician Management Group, LLC
|
| ZIP code: | 35805 (Companies in Madison, 35805) |
| County: | Madison |
| Place of Formation: | Madison County |
| Registered Office Street Address: | 2094 WESTCORP BLVD SWHUNTSVILLE, AL 35805 |
Activities
ADMINISTRATIVE SERVICES TO PHYSICIANS AND PHYSICIANS GROUPS
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MEDICAL DATA SOLUTIONS LLC PROFIT SHARING PLAN | 2011 | 631191763 | 2012-10-15 | MEDICAL DATA SOLUTIONS LLC | 16 | |||||||||||||||||||||||||||||||||||||||||||||
|
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| Administrator’s EIN | 631191763 |
| Plan administrator’s name | MEDICAL DATA SOLUTIONS LLC |
| Plan administrator’s address | 520 MADISON STREET STE A, HUNTSVILLE, AL, 35801 |
| Administrator’s telephone number | 2565334033 |
Number of participants as of the end of the plan year
| Other retired or separated participants entitled to future benefits | 16 |
Signature of
| Role | Plan administrator |
| Date | 2012-06-25 |
| Name of individual signing | R.L. FORTIN |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | DFE |
| Date | 2012-09-26 |
| Name of individual signing | RENE FORTIN |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1998-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2565334033 |
| Plan sponsor’s mailing address | 520 MADISON STREET STE A, HUNTSVILLE, AL, 35801 |
| Plan sponsor’s address | 520 MADISON STREET STE A, HUNTSVILLE, AL, 35801 |
Plan administrator’s name and address
| Administrator’s EIN | 631191763 |
| Plan administrator’s name | MEDICAL DATA SOLUTIONS LLC |
| Plan administrator’s address | 520 MADISON STREET STE A, HUNTSVILLE, AL, 35801 |
| Administrator’s telephone number | 2565334033 |
Number of participants as of the end of the plan year
| Other retired or separated participants entitled to future benefits | 16 |
Signature of
| Role | Plan administrator |
| Date | 2011-10-14 |
| Name of individual signing | R.L. FORTIN |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1998-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2565334033 |
| Plan sponsor’s mailing address | 520 MADISON STREET SUITE A, HUNTSVILLE, AL, 35801 |
| Plan sponsor’s address | 2009 GALLATIN STREET, HUNTSVILLE, AL, 35801 |
Plan administrator’s name and address
| Administrator’s EIN | 631191763 |
| Plan administrator’s name | MEDICAL DATA SOLUTIONS LLC |
| Plan administrator’s address | 520 MADISON STREET SUITE A, HUNTSVILLE, AL, 35801 |
| Administrator’s telephone number | 2565334033 |
Number of participants as of the end of the plan year
| Retired or separated participants receiving benefits | 16 |
Signature of
| Role | Plan administrator |
| Date | 2010-10-13 |
| Name of individual signing | RENE FORTIN |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| FORTIN, RENE L | Member | 520 MADISON STREET STE AHUNTSVILLE, AL 35801 |
| BROWN, MICHAEL WAYNE | Member | No data |
| KRAUS, THOMAS J | Member | 2721 WHISTLER LANEOWNES CROSSROADS, AL 35763 |
| RICHARDSON, RICHARD P | Member | 3000 HONORS ROWOWENS CROSS ROAD, AL 35763 |
| HUMPHREY, W R | Member | No data |
| GOETSCH, ALLAN | Member | No data |
| SERIO, ROBERT | Member | No data |
| STANLEY, C ROBERT | Member | 382 MULBERRY ROADHAZEL GREEN, AL 35750 |
| Name | Role | Address |
|---|---|---|
| FORTIN, R L | Agent | 520 MADISON STREET STE AHUNTSVILLE, AL 35801 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2006-06-20 | Name Change | Physician Management Group, LLC | Medical Data Solutions, LLC |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
