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Haley Dermatology, LLC

Details

Name: Haley Dermatology, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 06 Nov 2002 (22 years ago) (Companies founded in November 2002)
Entity Number: 000-685-899
Register Number: 000685899
ZIP code: 36532 (Companies in Baldwin, 36532)
County: Baldwin
Place of Formation: Jefferson County
Principal Address: FAIRHOPE, AL
Registered Office Street Address: 202 ROCK CREEK PKWYFAIRHOPE, AL 36532

Activities DERMATOLOGY PRACTICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1194891150 2006-11-28 2012-01-13 202 ROCK CREEK PARKWAY, FAIRHOPE, AL, 365323349, US 202 ROCK CREEK PKWY, FAIRHOPE, AL, 365323349, US

Contacts
Phone +1 251-928-3844
Fax 2519283353

Authorized person
Name DR. HEATHER R HALEY
Role OWNER PRESIDENT
Phone 2519283844

Taxonomy
Taxonomy Code 173000000X - Legal Medicine
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
HALEY DERMATOLOGY, LLC RETIREMENT PLAN 2020 113661727 2021-02-04 HALEY DERMATOLOGY, LLC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2519283844
Plan sponsor’s address 202 ROCK CREEK PARKWAY, FAIRHOPE, AL, 36532
HALEY DERMATOLOGY, LLC RETIREMENT PLAN 2019 113661727 2020-10-13 HALEY DERMATOLOGY, LLC 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2519283844
Plan sponsor’s address 202 ROCK CREEK PARKWAY, FAIRHOPE, AL, 36532
HALEY DERMATOLOGY, LLC RETIREMENT PLAN 2018 113661727 2019-08-28 HALEY DERMATOLOGY, LLC 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2519283844
Plan sponsor’s address 202 ROCK CREEK PARKWAY, FAIRHOPE, AL, 36532
HALEY DERMATOLOGY, LLC RETIREMENT PLAN 2017 113661727 2018-07-19 HALEY DERMATOLOGY, LLC 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2519283844
Plan sponsor’s address 202 ROCK CREEK PARKWAY, FAIRHOPE, AL, 36532
HALEY DERMATOLOGY, LLC RETIREMENT PLAN 2017 113661727 2018-06-05 HALEY DERMATOLOGY, LLC 27
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2519283844
Plan sponsor’s address 202 ROCK CREEK PARKWAY, FAIRHOPE, AL, 36532
HALEY DERMATOLOGY, LLC RETIREMENT PLAN 2016 113661727 2017-05-23 HALEY DERMATOLOGY, LLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2519283844
Plan sponsor’s address 202 ROCK CREEK PARKWAY, FAIRHOPE, AL, 36532
HALEY DERMATOLOGY, LLC RETIREMENT PLAN 2015 113661727 2016-09-13 HALEY DERMATOLOGY, LLC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2519283844
Plan sponsor’s address 202 ROCK CREEK PARKWAY, FAIRHOPE, AL, 36532
HALEY DERMATOLOGY, LLC RETIREMENT PLAN 2014 113661727 2015-06-11 HALEY DERMATOLOGY, LLC 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2519283844
Plan sponsor’s address 202 ROCK CREEK PARKWAY, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2015-06-11
Name of individual signing CHRISTOPHER LEE HALEY
HALEY DERMATOLOGY, LLC RETIREMENT PLAN 2013 113661727 2014-07-30 HALEY DERMATOLOGY, LLC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2519283844
Plan sponsor’s address 202 ROCK CREEK PARKWAY, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2014-07-30
Name of individual signing CHRISTOPHER LEE HALEY
HALEY DERMATOLOGY, LLC RETIREMENT PLAN 2012 113661727 2013-06-25 HALEY DERMATOLOGY, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 2519283844
Plan sponsor’s address 202 ROCK CREEK PARKWAY, FAIRHOPE, AL, 36532

Signature of
Role Plan administrator
Date 2013-06-25
Name of individual signing CHRISTOPHER LEE HALEY

Agent

Name Role
HALEY, HEATHER Agent

Member

Name Role
HALEY, HEATHER Member

Related by officers

No related officers

Related by address

FAIRHOPE, AL

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202 ROCK CREEK PKWYFAIRHOPE, AL 36532

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Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State

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