| Name: | Foley Walk-In Med Care, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 22 Feb 1999 (26 years ago) (Companies founded in February 1999) |
| Entity Number: | 000-663-451 |
| Register Number: | 000663451 |
| ZIP code: | 36535 (Companies in Baldwin, 36535) |
| County: | Baldwin |
| Place of Formation: | Baldwin County |
| Principal Address: | FOLEY, AL |
| Registered Office Street Address: | 1440 N MCKENZIE STREETFOLEY, AL 36535 |
Activities
PERFORM MEDICAL SERVICES AND SALES OF MEDICAL RELATED EQUIPMENT
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1396838199 | 2006-10-02 | 2008-07-01 | 1440 N MCKENZIE ST, FOLEY, AL, 365352234, US | 1440 N MCKENZIE ST, FOLEY, AL, 365352234, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 251-970-3400 |
| Fax | 2519703406 |
Authorized person
| Name | AWADHESH K GUPTA |
| Role | OWNER |
| Phone | 2519703400 |
Taxonomy
| Taxonomy Code | 207R00000X - Internal Medicine Physician |
| Is Primary | Yes |
| Taxonomy Code | 225100000X - Physical Therapist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 529901230 |
| State | AL |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | 51008296 |
| State | AL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FOLEY WALK-IN MED CARE LLC PENSION PLAN | 2012 | 631221930 | 2013-07-25 | FOLEY WALK-IN MED CARE LLC | 5 | |||||||||||||||||||||||||||||||||||||
|
||||||||||||||||||||||||||||||||||||||||||
| Administrator’s EIN | 631221930 |
| Plan administrator’s name | FOLEY WALK-IN MED CARE LLC |
| Plan administrator’s address | 1440 N MCKENZIE STREET, FOLEY, AL, 36535 |
| Administrator’s telephone number | 2513703400 |
Signature of
| Role | Plan administrator |
| Date | 2013-07-25 |
| Name of individual signing | AWADHESH K. GUPTA |
| Role | Employer/plan sponsor |
| Date | 2013-07-25 |
| Name of individual signing | AWADHESH K. GUPTA |
| File | View Page |
| Three-digit plan number (PN) | 003 |
| Effective date of plan | 2003-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2519703400 |
| Plan sponsor’s address | 1440 N MCKENZIE STREET, FOLEY, AL, 36535 |
Plan administrator’s name and address
| Administrator’s EIN | 631221930 |
| Plan administrator’s name | FOLEY WALK-IN MED CARE LLC |
| Plan administrator’s address | 1440 N MCKENZIE STREET, FOLEY, AL, 36535 |
| Administrator’s telephone number | 2513703400 |
Signature of
| Role | Plan administrator |
| Date | 2012-07-25 |
| Name of individual signing | AWADHESH K. GUPTA |
| File | View Page |
| Three-digit plan number (PN) | 003 |
| Effective date of plan | 2003-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2519703400 |
| Plan sponsor’s address | 1440 N MCKENZIE STREET, FOLEY, AL, 36535 |
Plan administrator’s name and address
| Administrator’s EIN | 631221930 |
| Plan administrator’s name | FOLEY WALK-IN MED CARE LLC |
| Plan administrator’s address | 1440 N MCKENZIE STREET, FOLEY, AL, 36535 |
| Administrator’s telephone number | 2519703400 |
Signature of
| Role | Plan administrator |
| Date | 2011-07-14 |
| Name of individual signing | AWADHESH K. GUPTA |
| Role | Employer/plan sponsor |
| Date | 2011-07-14 |
| Name of individual signing | AWADHESH K. GUPTA |
| File | View Page |
| Three-digit plan number (PN) | 003 |
| Effective date of plan | 2003-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2519703400 |
| Plan sponsor’s address | 1440 N MCKENZIE STREET, FOLEY, AL, 36535 |
Plan administrator’s name and address
| Administrator’s EIN | 631221930 |
| Plan administrator’s name | FOLEY WALK-IN MED CARE LLC |
| Plan administrator’s address | 1440 N MCKENZIE STREET, FOLEY, AL, 36535 |
| Administrator’s telephone number | 2519703400 |
Signature of
| Role | Plan administrator |
| Date | 2010-09-29 |
| Name of individual signing | AWADHESH K. GUPTA |
| Role | Employer/plan sponsor |
| Date | 2010-09-29 |
| Name of individual signing | AWADHESH K. GUPTA |
| Name | Role |
|---|---|
| GUPTA, AWADHESH K | Agent |
| Name | Role |
|---|---|
| GUPTA, AWADHESH K | Member |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
