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Occupational Health Center, LLC

Details

Name: Occupational Health Center, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Dissolved
Date of registration: 02 Feb 1998 (27 years ago)
Date of dissolution: 06 Nov 2018
Entity Number: 000-658-735
Register Number: 000658735
County: Lauderdale
Place of Formation: Lauderdale County
Principal Address: FLORENCE, AL
Registered Office Street Address: 1949 FLROENCE BLVDFLORENCE, AL 35630
Registered Office Street Address ZIP Code: 35630

Activities OCCUPATIONAL MEDICINE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1972925162 2014-01-08 2014-01-08 1949 FLORENCE BLVD, FLORENCE, AL, 356302729, US 1949 FLORENCE BLVD, FLORENCE, AL, 356302729, US

Contacts
Phone +1 256-760-1977
Fax 2567649982

Authorized person
Name MS. TONYA M LANE
Role OFFICE MANAGER
Phone 2567601977

Taxonomy
Taxonomy Code 261QX0100X - Occupational Medicine Clinic/Center
License Number 1-056150
State AL
Is Primary Yes

Other Provider Identifiers
Issuer ALABAMA BOARD OF NURSING
Number 1-056150
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
OCCUPATIONAL HEALTH CENTER, LLC 401(K) PROFIT SHARING PLAN 2016 631191998 2017-08-28 OCCUPATIONAL HEALTH CENTER,LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2567601977
Plan sponsor’s address 1949 FLORENCE BOULEVARD, FLORENCE, AL, 35630

Signature of
Role Plan administrator
Date 2017-08-28
Name of individual signing GARY W DANIEL
OCCUPATIONAL HEALTH CENTER, LLC 401(K) PROFIT SHARING PLAN 2016 631191998 2017-08-28 OCCUPATIONAL HEALTH CENTER, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2567601977
Plan sponsor’s address 1949 FLORENCE BOULEVARD, FLORENCE, AL, 35630

Signature of
Role Plan administrator
Date 2017-08-28
Name of individual signing GARY W DANIEL
OCCUPATIONAL HEALTH CENTER, LLC 401(K) PROFIT SHARING PLAN 2015 631191998 2016-05-20 OCCUPATIONAL HEALTH CENTER, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2567601977
Plan sponsor’s address 1949 FLORENCE BOULEVARD, FLORENCE, AL, 35630

Signature of
Role Plan administrator
Date 2016-05-20
Name of individual signing GARY DANIEL
OCCUPATIONAL HEALTH CENTER, LLC 401(K) PROFIT SHARING PLAN 2014 631191998 2015-06-23 OCCUPATIONAL HEALTH CENTER, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2567601977
Plan sponsor’s address 1949 FLORENCE BOULEVARD, FLORENCE, AL, 35630

Signature of
Role Plan administrator
Date 2015-06-23
Name of individual signing GARY DANIEL
OCCUPATIONAL HEALTH CENTER, LLC 401(K) PROFIT SHARING PLAN 2013 631191998 2014-06-23 OCCUPATIONAL HEALTH CENTER, LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2567601977
Plan sponsor’s address 1949 FLORENCE BOULEVARD, FLORENCE, AL, 35630

Signature of
Role Plan administrator
Date 2014-06-23
Name of individual signing GARY DANIEL
OCCUPATIONAL HEALTH CENTER, LLC 401(K) PROFIT SHARING PLAN 2012 631191998 2013-06-17 OCCUPATIONAL HEALTH CENTER, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2567601977
Plan sponsor’s address 1949 FLORENCE BOULEVARD, FLORENCE, AL, 35630

Signature of
Role Plan administrator
Date 2013-06-17
Name of individual signing GARY DANIEL
OCCUPATIONAL HEALTH , LLC 401(K) PROFIT SHARING PLAN 2011 631191998 2012-07-03 OCCUPATIONAL HEALTH CENTER, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2567601977
Plan sponsor’s address 1949 FLORENCE BOULEVARD, FLORENCE, AL, 35630

Plan administrator’s name and address
Administrator’s EIN 631191998
Plan administrator’s name OCCUPATIONAL HEALTH CENTER, LLC
Plan administrator’s address 1949 FLORENCE BOULEVARD, FLORENCE, AL, 35630
Administrator’s telephone number 2567601977

Signature of
Role Plan administrator
Date 2012-07-03
Name of individual signing GARY DANIEL
OCCUPATIONAL HEALTH CENTER, LLC 401(K) PROFIT SHARING PLAN 2010 631191998 2011-06-21 OCCUPATIONAL HEALTH CENTER, LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 2567601977
Plan sponsor’s address 1949 FLORENCE BOULEVARD, FLORENCE, AL, 35630

Plan administrator’s name and address
Administrator’s EIN 631191998
Plan administrator’s name OCCUPATIONAL HEALTH CENTER, LLC
Plan administrator’s address 1949 FLORENCE BOULEVARD, FLORENCE, AL, 35630
Administrator’s telephone number 2567601977

Signature of
Role Plan administrator
Date 2011-06-21
Name of individual signing GARY W DANIEL
OCCUPATIONAL HEALTH CENTER, LLC 401(K) PROFIT SHARING PLAN 2009 631191998 2010-08-20 OCCUPATIONAL HEALTH CENTER, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2567601977
Plan sponsor’s address 1949 FLORENCE BOULEVARD, FLORENCE, AL, 35630

Plan administrator’s name and address
Administrator’s EIN 631191998
Plan administrator’s name OCCUPATIONAL HEALTH CENTER, LLC
Plan administrator’s address 1949 FLORENCE BOULEVARD, FLORENCE, AL, 35630
Administrator’s telephone number 2567601977

Signature of
Role Plan administrator
Date 2010-08-20
Name of individual signing GARY W DANIEL
Role Employer/plan sponsor
Date 2010-08-20
Name of individual signing GARY W DANIEL

Agent

Name Role Address
DANIEL, GARY W Agent 2397 COUNTY ROAD 698HOLLY POND, AL 35083

Member

Name Role Address
DANIEL, GARY W Member 2397 COUNTY ROAD 698HOLLY POND, AL 35083

Related by officers

DANIEL, GARY W

278 WHOLESALE LLC D and D, LLC SafetySouth, LLC

Related by address

FLORENCE, AL

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Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State

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