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Dothan Surgery Center LLC

Details

Name: Dothan Surgery Center LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 15 Feb 2001 (24 years ago) (Companies founded in February 2001)
Entity Number: 000-674-138
Register Number: 000674138
ZIP code: 36301 (Companies in Houston, 36301)
County: Houston
Place of Formation: Houston County
Registered Office Street Address: 1450 ROSS CLARK CIRCLEDOTHAN, AL 36301

Activities LEASE/OPERATE AN AMBULATORY SURGERY CENTER

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1003815242 2005-07-19 2007-07-27 1450 ROSS CLARK CIR, SUITE 4, DOTHAN, AL, 363014736, US 1450 ROSS CLARK CIR, SUITE 4, DOTHAN, AL, 363014736, US

Contacts
Phone +1 334-793-3442
Fax 3347933318

Authorized person
Name MRS. DENISE DAVIS HARRINGTON
Role ADMINISTRATOR
Phone 3347933442

Taxonomy
Taxonomy Code 261QA1903X - Ambulatory Surgical Clinic/Center
License Number 10431
State AL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number ASC0066C
State AL

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
6M7T7 Obsolete Non-Manufacturer 2011-12-27 2024-06-27 No data 2025-06-25

Contact Information
POC BERRY SOWELL
Phone +1 334-793-3442
Fax +1 334-793-3318
Address 1450 ROSS CLARK CIR STE 4, DOTHAN, AL, 36301 4736, UNITED STATES

Ownership of Offeror Information
Highest Level Owner Information not Available
Immediate Level Owner Information not Available
List of Offerors (0) Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DOTHAN SURGERY CENTER, LLC 401(K) PLAN 2023 631267139 2024-10-14 DOTHAN SURGERY CENTER, LLC 86
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-07-01
Business code 621111
Sponsor’s telephone number 3347933442
Plan sponsor’s address 1450 ROSS CLARK CIRCLE, SUITE 4, DOTHAN, AL, 363014736
DOTHAN SURGERY CENTER, LLC 401(K) PLAN 2022 631267139 2023-10-03 DOTHAN SURGERY CENTER, LLC 86
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-07-01
Business code 621111
Sponsor’s telephone number 3347933442
Plan sponsor’s address 1450 ROSS CLARK CIRCLE, SUITE 4, DOTHAN, AL, 363014736
DOTHAN SURGERY CENTER, LLC 401(K) PLAN 2021 631267139 2022-10-17 DOTHAN SURGERY CENTER, LLC 86
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-07-01
Business code 621111
Sponsor’s telephone number 3347933442
Plan sponsor’s address 1450 ROSS CLARK CIRCLE, SUITE 4, DOTHAN, AL, 363014736
DOTHAN SURGERY CENTER, LLC 401(K) PLAN 2020 631267139 2021-11-09 DOTHAN SURGERY CENTER, LLC 78
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-07-01
Business code 621111
Sponsor’s telephone number 3347933442
Plan sponsor’s address 1450 ROSS CLARK CIRCLE, SUITE 4, DOTHAN, AL, 363014736
DOTHAN SURGERY CENTER, LLC 401(K) PLAN 2020 631267139 2021-11-22 DOTHAN SURGERY CENTER, LLC 86
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-07-01
Business code 621111
Sponsor’s telephone number 3347933442
Plan sponsor’s address 1450 ROSS CLARK CIRCLE, SUITE 4, DOTHAN, AL, 363014736
DOTHAN SURGERY CENTER, LLC 401(K) PLAN 2020 631267139 2021-10-08 DOTHAN SURGERY CENTER, LLC 55
Three-digit plan number (PN) 001
Effective date of plan 2002-07-01
Business code 621111
Sponsor’s telephone number 3347933442
Plan sponsor’s address 1450 ROSS CLARK CIRCLE, SUITE 4, DOTHAN, AL, 363014736
DOTHAN SURGERY CENTER, LLC 401(K) PLAN 2019 631267139 2020-10-12 DOTHAN SURGERY CENTER, LLC 57
Three-digit plan number (PN) 001
Effective date of plan 2002-07-01
Business code 621111
Sponsor’s telephone number 3347933442
Plan sponsor’s address 1450 ROSS CLARK CIRCLE, SUITE 4, DOTHAN, AL, 363014736
DOTHAN SURGERY CENTER, LLC 401(K) PLAN 2019 631267139 2021-11-22 DOTHAN SURGERY CENTER, LLC 83
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-07-01
Business code 621111
Sponsor’s telephone number 3347933442
Plan sponsor’s address 1450 ROSS CLARK CIRCLE, SUITE 4, DOTHAN, AL, 363014736
DOTHAN SURGERY CENTER, LLC 401(K) PLAN 2018 631267139 2019-10-14 DOTHAN SURGERY CENTER, LLC 86
Three-digit plan number (PN) 001
Effective date of plan 2002-07-01
Business code 621111
Sponsor’s telephone number 3347933442
Plan sponsor’s address 1450 ROSS CLARK CIRCLE, SUITE 4, DOTHAN, AL, 363014736
DOTHAN SURGERY CENTER, LLC 401(K) PLAN 2017 631267139 2018-10-15 DOTHAN SURGERY CENTER, LLC 74
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2002-07-01
Business code 621111
Sponsor’s telephone number 3347933442
Plan sponsor’s address 1450 ROSS CLARK CIRCLE, SUITE 4, DOTHAN, AL, 363014736

Agent

Name Role
SOWELL, W. BERRY Agent

Member

Name Role
HOUSTON COUNTY HEALTH CARE AUTHORITY Member

Related by officers

HOUSTON COUNTY HEALTH CARE AUTHORITY

SSM, LLC Southeast Cancer Care Network, LLC

Related by address

1450 ROSS CLARK CIRCLEDOTHAN, AL 36301

Best Alabama, L.L.C.

Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State

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