| Name: | Alabama Family Medical Center, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 05 Dec 2001 (23 years ago) |
| Entity Number: | 000-679-135 |
| Register Number: | 000679135 |
| County: | Tuscaloosa |
| Place of Formation: | Tuscaloosa County |
| Principal Address: | TUSCALOOSA, AL |
| Registered Office Street Address: | 1435 SECOND CT EASTTUSCALOOSA, AL 35401 |
| Registered Office Street Address ZIP Code: | 35401 |
Activities
PERFORM PRIMARY MEDICAL CARE
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245226489 | 2005-09-22 | 2018-06-11 | 1718 VETERANS MEMORIAL PKWY, SUITE C, TUSCALOOSA, AL, 354044708, US | 1718 VETERANS MEMORIAL PKWY, SUITE C, TUSCALOOSA, AL, 35404, US | |||||||||||||||||||||||||||
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| Phone | +1 205-553-1900 |
| Fax | 2055534575 |
Authorized person
| Name | RAMESH B PERAMSETTY |
| Role | MEDICAL DIRECTOR |
| Phone | 2055531900 |
Taxonomy
| Taxonomy Code | 101YM0800X - Mental Health Counselor |
| License Number | 24373 |
| State | AL |
| Is Primary | No |
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| License Number | 21446 |
| State | AL |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALABAMA FAMILY MEDICAL CENTER RETIREMENT SAVINGS PLAN | 2021 | 631288363 | 2022-04-20 | ALABAMA FAMILY MEDICAL CENTER | 116 | |||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2022-04-20 |
| Name of individual signing | RAMESH PERAMSETTY |
| Role | Employer/plan sponsor |
| Date | 2022-04-20 |
| Name of individual signing | RAMESH PERAMSETTY |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2055331900 |
| Plan sponsor’s address | 1718 VETERAN'S MEMORIAL PARKWAY, TUSCALOOSA, AL, 35404 |
Signature of
| Role | Plan administrator |
| Date | 2021-10-13 |
| Name of individual signing | RAMESH PERAMSETTY |
| Role | Employer/plan sponsor |
| Date | 2021-10-13 |
| Name of individual signing | RAMESH PERAMSETTY |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2055331900 |
| Plan sponsor’s address | 1718 VETERAN'S MEMORIAL PARKWAY, TUSCALOOSA, AL, 35404 |
Signature of
| Role | Plan administrator |
| Date | 2022-04-15 |
| Name of individual signing | RAMESH PERAMSETTY |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2055331900 |
| Plan sponsor’s address | 1718 VETERAN'S MEMORIAL PARKWAY, TUSCALOOSA, AL, 35404 |
Signature of
| Role | Plan administrator |
| Date | 2020-10-02 |
| Name of individual signing | RAMESH PERAMSETTY |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2055331900 |
| Plan sponsor’s address | 1718 VETERAN'S MEMORIAL PARKWAY, TUSCALOOSA, AL, 35404 |
Signature of
| Role | Plan administrator |
| Date | 2019-10-14 |
| Name of individual signing | RAMESH PERAMSETTY |
| Role | Employer/plan sponsor |
| Date | 2019-10-14 |
| Name of individual signing | RAMESH PERAMSETTY |
| Name | Role | Address |
|---|---|---|
| PERAMSETTY, RAMESH B | Agent | 2905 LAKE COVE CIRCLETUSCALOOSA, AL 35406 |
| Name | Role | Address |
|---|---|---|
| PERAMSETTY, RAMESH B | Member | 2905 LAKE COVE CIRCLETUSCALOOSA, AL 35406 |
Date of last update: 15 Aug 2024
Sources: Alabama Secretary of State
