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Retina Specialists of North Alabama, LLC

Details

Name: Retina Specialists of North Alabama, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 11 Apr 2000 (25 years ago) (Companies founded in April 2000)
Entity Number: 000-669-460
Register Number: 000669460
ZIP code: 35630 (Companies in Lauderdale, 35630)
County: Lauderdale
Place of Formation: Madison County
Principal Address: HUNTSVILLE, AL
Registered Office Street Address: 401 MERIDIAN ST STE 400HUNTSVILLE, AL 35630

Activities MEDICAL PRACTICE

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
GFUBKLC8VHB1 2023-02-09 401 MERIDIAN ST STE 400, HUNTSVILLE, AL, 35811, 4719, USA 2101 HIGHLAND AVENUE, SUITE 350, BIRMINGHAM, AL, 35205, 4009, USA

Business Information
Congressional District 05
State/Country of Incorporation AL, USA
Activation Date 2022-01-12
Initial Registration Date 2020-12-31
Entity Start Date 2000-04-10
Fiscal Year End Close Date Dec 31

Points of Contacts
Electronic Business
Title PRIMARY POC
Name JESSICA BAKANE
Address 2101 HIGHLAND AVENUE, SUITE 350, BIRMINGHAM, AL, 35205, USA
Government Business
Title PRIMARY POC
Name JESSICA BAKANE
Address 2101 HIGHLAND AVENUE, SUITE 350, BIRMINGHAM, AL, 35205, USA
Past Performance Information not Available

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1184839268 2007-05-11 2017-04-10 1201 11TH AVE S STE 300, BIRMINGHAM, AL, 352053422, US 216 SOUTH MARENGO ST, SUITE K, FLORENCE, AL, 356306034, US

Contacts
Phone +1 256-740-0601

Authorized person
Name DR. SCOTT E DORIN
Role MEMBER
Phone 2567400601

Taxonomy
Taxonomy Code 207W00000X - Ophthalmology Physician
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 529906990
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
THE RETINA SPECIALISTS OF NORTH ALABAMA, LLC 401(K) PLAN 2023 631248340 2024-10-02 RETINA SPECIALISTS OF NORTH ALABAMA, LLC 76
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2565398851
Plan sponsor’s address 401 MERIDIAN STREET SUITE 400, HUNTSVILLE, AL, 35801
THE RETINA SPECIALISTS OF NORTH ALABAMA, LLC 401(K) PLAN 2022 631248340 2023-10-03 RETINA SPECIALISTS OF NORTH ALABAMA, LLC 56
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2565398851
Plan sponsor’s address 401 MERIDIAN STREET SUITE 400, HUNTSVILLE, AL, 35801
THE RETINA SPECIALISTS OF NORTH ALABAMA, LLC 401(K) PLAN 2021 631248340 2022-09-07 RETINA SPECIALISTS OF NORTH ALABAMA, LLC 56
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2565398851
Plan sponsor’s address 401 MERIDIAN STREET SUITE 400, HUNTSVILLE, AL, 35801

Signature of
Role Plan administrator
Date 2022-09-07
Name of individual signing JEFF DANCE
THE RETINA SPECIALISTS OF NORTH ALABAMA, LLC 401(K) PLAN 2020 631248340 2021-10-08 RETINA SPECIALISTS OF NORTH ALABAMA, LLC 56
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2565398851
Plan sponsor’s address 401 MERIDIAN STREET SUITE 400, HUNTSVILLE, AL, 35801

Signature of
Role Plan administrator
Date 2021-10-08
Name of individual signing JEFF DANCE
THE RETINA SPECIALISTS OF NORTH ALABAMA, LLC 401(K) PLAN 2019 631248340 2020-10-15 RETINA SPECIALISTS OF NORTH ALABAMA, LLC 52
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2565398851
Plan sponsor’s address 401 MERIDIAN STREET SUITE 400, HUNTSVILLE, AL, 35801
THE RETINA SPECIALISTS OF NORTH ALABAMA, LLC 401(K) PLAN 2018 631248340 2019-07-30 RETINA SPECIALISTS OF NORTH ALABAMA, LLC 47
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2565398851
Plan sponsor’s address 401 MERIDIAN STREET SUITE 400, HUNTSVILLE, AL, 35801
THE RETINA SPECIALISTS OF NORTH ALABAMA, LLC 401(K) PLAN 2017 631248340 2018-07-26 RETINA SPECIALISTS OF NORTH ALABAMA, LLC 46
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2565398851
Plan sponsor’s address 401 MERIDIAN STREET SUITE 400, HUNTSVILLE, AL, 35801
THE RETINA SPECIALISTS OF NORTH ALABAMA, LLC 401(K) PLAN 2016 631248340 2017-07-20 RETINA SPECIALISTS OF NORTH ALABAMA, LLC 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2565398851
Plan sponsor’s address 401 MERIDIAN STREET SUITE 400, HUNTSVILLE, AL, 35801
THE RETINA SPECIALISTS OF NORTH ALABAMA, LLC 401(K) PLAN 2015 631248340 2016-07-30 RETINA SPECIALISTS OF NORTH ALABAMA, LLC 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2565398851
Plan sponsor’s address 401 MERIDIAN STREET SUITE 400, HUNTSVILLE, AL, 35801
THE RETINA SPECIALISTS OF NORTH ALABAMA, LLC 401(K) PLAN 2014 631248340 2015-07-29 RETINA SPECIALISTS OF NORTH ALABAMA, LLC 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2565398851
Plan sponsor’s address 401 MERIDIAN STREET SUITE 400, HUNTSVILLE, AL, 35801

Signature of
Role Plan administrator
Date 2015-07-29
Name of individual signing DR. JAMES B. BYRNE, JR.

Agent

Name Role
BYRNE, JAMES B JR Agent

Member

Name Role
BYRNE, JAMES B JR Member

Related by officers

BYRNE, JAMES B JR

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Related by address

HUNTSVILLE, AL

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Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State

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