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The Radiology Clinic, LLC

Details

Name: The Radiology Clinic, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 01 Apr 2002 (23 years ago)
Entity Number: 000-681-504
Register Number: 000681504
County: Tuscaloosa
Place of Formation: Tuscaloosa County
Principal Address: TUSCALOOSA, AL
Registered Office Street Address: 208 MCFARLAND CIRCLE NORTHTUSCALOOSA, AL 35406
Registered Office Street Address ZIP Code: 35406

Activities MEDICAL PRACTICE/RADIOLOGY/DIAGNOSTIC IMAGING

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
MFPNGXTKSL43 2025-03-21 208 MCFARLAND CIR N, TUSCALOOSA, AL, 35406, 1800, USA 208 MCFARLAND CIR N, TUSCALOOSA, AL, 35406, 1800, USA

Business Information
Division Name THE RADIOLOGY CLINIC, LLC
Division Number THE RADIOL
Congressional District 07
State/Country of Incorporation AL, USA
Activation Date 2024-03-21
Initial Registration Date 2017-05-24
Entity Start Date 2002-04-01
Fiscal Year End Close Date Dec 31

Service Classifications
NAICS Codes 621512

Points of Contacts
Electronic Business
Title PRIMARY POC
Name DEBBIE CARABIN
Role CFO
Address 208 MCFARLAND CIRCLE N, TUSCALOOSA, AL, 35406, 1800, USA
Government Business
Title PRIMARY POC
Name LEIGH WRIGHT
Role DIRECTOR OF PRIVACY & COMPLIANCE
Address 208 MCFARLAND CIRCLE, NORTH, TUSCALOOSA, AL, 35406, 1800, USA
Past Performance
Title PRIMARY POC
Name CHARLOTTE WILLIAMS
Role PROVIDER RELATIONS
Address 208 MCFARLAND CIRCLE, NORTH, TUSCALOOSA, AL, 35406, USA
Title ALTERNATE POC
Name CHARLOTTE WILLIAMS
Role PROVIDER RELATIONS
Address 208 MCFARLAND CIRCLE, NORTH, TUSCALOOSA, AL, 35406, USA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1649235243 2006-04-18 2022-09-01 208 MCFARLAND CIR N, TUSCALOOSA, AL, 354061800, US 208 MCFARLAND CIR N, TUSCALOOSA, AL, 354061800, US

Contacts
Phone +1 205-345-7000
Fax 2053436700

Authorized person
Name JAMES E LEITNER
Role CHIEF EXECUTIVE OFFICER
Phone 2053430900

Taxonomy
Taxonomy Code 2085R0202X - Diagnostic Radiology Physician
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 000060017
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
THE RADIOLOGY CLINIC 401(K) PROFIT SHARING PLAN 2023 630313602 2024-07-07 THE RADIOLOGY CLINIC, LLC 113
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 2053430945
Plan sponsor’s address 208 MCFARLANE CIRCLE N., SUITE 200, TUSCALOOSA, AL, 35406

Signature of
Role Plan administrator
Date 2024-07-07
Name of individual signing DEBRA CARABIN
THE RADIOLOGY CLINIC, LLC CASH BALANCE PENSION PLAN 2022 630313602 2023-04-17 THE RADIOLOGY CLINIC, LLC 47
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 2053430945
Plan sponsor’s address 208 MCFARLAND CIRCLE NORTH, TUSCALOOSA, AL, 35406
THE RADIOLOGY CLINIC 401(K) PROFIT SHARING PLAN 2022 630313602 2023-07-20 THE RADIOLOGY CLINIC, LLC 109
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 2053430945
Plan sponsor’s address 208 MCFARLANE CIRCLE N., SUITE 200, TUSCALOOSA, AL, 35406

Signature of
Role Plan administrator
Date 2023-07-20
Name of individual signing DEBRA CARABIN
THE RADIOLOGY CLINIC 401(K) PROFIT SHARING PLAN 2021 630313602 2022-07-28 THE RADIOLOGY CLINIC, LLC 106
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 2053457000
Plan sponsor’s address 208 MCFARLAND CIRCLE NORTH, TUSCALOOSA, AL, 354061800

Signature of
Role Plan administrator
Date 2022-07-28
Name of individual signing CHRISTINA OWEN
THE RADIOLOGY CLINIC, LLC CASH BALANCE PENSION PLAN 2021 630313602 2022-08-01 THE RADIOLOGY CLINIC, LLC 47
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 2053430945
Plan sponsor’s address 208 MCFARLAND CIRCLE NORTH, TUSCALOOSA, AL, 35406

Signature of
Role Plan administrator
Date 2022-08-01
Name of individual signing DEBRA CARABIN
THE RADIOLOGY CLINIC 401(K) PROFIT SHARING PLAN 2020 630313602 2021-09-15 THE RADIOLOGY CLINIC, LLC 99
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1984-07-01
Business code 621111
Sponsor’s telephone number 2053457000
Plan sponsor’s address 208 MCFARLAND CIRCLE NORTH, TUSCALOOSA, AL, 354061800

Signature of
Role Plan administrator
Date 2021-09-15
Name of individual signing CHRISTINA OWEN
THE RADIOLOGY CLINIC, LLC CASH BALANCE PENSION PLAN 2020 630313602 2021-09-22 THE RADIOLOGY CLINIC, LLC 43
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2020-01-01
Business code 621111
Sponsor’s telephone number 2053430945
Plan sponsor’s address 208 MCFARLAND CIRCLE NORTH, TUSCALOOSA, AL, 35406

Signature of
Role Plan administrator
Date 2021-09-22
Name of individual signing DEBRA CARABIN
THE RADIOLOGY CLINIC DISABILITY AND LIFE PLAN 2018 630313602 2020-05-22 THE RADIOLOGY CLINIC, LLC 97
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2053430945
Plan sponsor’s DBA name THE RADIOLOGY CLINIC, LLC
Plan sponsor’s mailing address 208 MCFARLAND CIR N, TUSCALOOSA, AL, 354061800
Plan sponsor’s address 208 MCFARLAND CIR N, TUSCALOOSA, AL, 354061800

Number of participants as of the end of the plan year
Active participants 0

Signature of
Role Plan administrator
Date 2020-05-22
Name of individual signing DEBRA CARABIN
Valid signature Filed with authorized/valid electronic signature
THE RADIOLOGY CLINIC DISABILITY AND LIFE PLAN 2018 630313602 2019-07-25 THE RADIOLOGY CLINIC, LLC 97
Three-digit plan number (PN) 501
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2053430945
Plan sponsor’s DBA name THE RADIOLOGY CLINIC, LLC
Plan sponsor’s mailing address 208 MCFARLAND CIR N, TUSCALOOSA, AL, 354061800
Plan sponsor’s address 208 MCFARLAND CIR N, TUSCALOOSA, AL, 354061800

Number of participants as of the end of the plan year
Active participants 101

Signature of
Role Plan administrator
Date 2019-07-25
Name of individual signing DEBRA CARABIN
Valid signature Filed with authorized/valid electronic signature
THE RADIOLOGY CLINIC DISABILITY AND LIFE PLAN 2017 630313602 2018-07-26 THE RADIOLOGY CLINIC, LLC 96
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2053430945
Plan sponsor’s DBA name THE RADIOLOGY CLINIC, LLC
Plan sponsor’s mailing address 208 MCFARLAND CIR N, TUSCALOOSA, AL, 354061800
Plan sponsor’s address 208 MCFARLAND CIR N, TUSCALOOSA, AL, 354061800

Number of participants as of the end of the plan year
Active participants 97

Signature of
Role Plan administrator
Date 2018-07-26
Name of individual signing DEBRA CARABIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-07-26
Name of individual signing DEBRA CARABIN
Valid signature Filed with authorized/valid electronic signature

Member

Name Role Address
HOLLEY, HOWARD C Member No data
VAUM, RICHARD C Member No data
SCHOLL, RUSSELL A Member No data
LUSHINGTON, J ALEXANDER JR Member No data
SPEED, J BYRON Member No data
DEVENNY, MICHAEL F Member No data
CALDWELL, ELIZABETH D Member No data
GUARISCO, MARGARET C Member 1317 CROWN CIRCLETUSCALOOSA, AL 35406
MILLER, G CHRISTOPHER Member No data
VEILLON, BERNARD J Member No data

Agent

Name Role
HUMBER, JOHN D Agent

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HOLLEY, HOWARD C

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VAUM, RICHARD C

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SCHOLL, RUSSELL A

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LUSHINGTON, J ALEXANDER JR

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SPEED, J BYRON

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DEVENNY, MICHAEL F

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CALDWELL, ELIZABETH D

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GUARISCO, MARGARET C

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MILLER, G CHRISTOPHER

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VEILLON, BERNARD J

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HUMBER, JOHN D

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MCGHEE, TIMOTHY L

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208 MCFARLAND CIRCLE NORTHTUSCALOOSA, AL 35406

701 13th St., L.L.C. 217 Fox Run, LLC Fox Run Rental, L.L.C. Simplified Medical Management, LLC The Radiology Group Realty, LLC

Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State

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