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Birmingham Family Wellness, LLC

Details

Name: Birmingham Family Wellness, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 27 Nov 2002 (22 years ago)
Entity Number: 000-686-206
Register Number: 000686206
County: Jefferson
Place of Formation: Jefferson County
Principal Address: FAIRFIELD, AL
Registered Office Street Address: 701 RICHARD PKWYFAIRFIELD, AL 35064
Registered Office Street Address ZIP Code: 35064

Activities PROVIDE MEDICAL SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1831227271 2007-02-28 2008-02-19 401 TUSCALOOSA AVE SW, BIRMINGHAM, AL, 352111416, US 401 TUSCALOOSA AVE SW, BIRMINGHAM, AL, 352111416, US

Contacts

Phone +1 205-783-9877
Fax 2057839866

Authorized person

Name DR. ANJANETTA LATRICE FOSTER
Role OWNER
Phone 2057839877

Taxonomy

Taxonomy Code 207R00000X - Internal Medicine Physician
License Number 18217
State AL
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BIRMINGHAM FAMILY WELLNESS RETIREMENT TRUST 2022 030498276 2023-08-10 BIRMINGHAM FAMILY WELLNESS 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-09-21
Business code 621111
Sponsor’s telephone number 2057839877
Plan sponsor’s address 652 LOMB AVE SW, BIRMINGHAM, AL, 35211

Signature of

Role Plan administrator
Date 2023-08-10
Name of individual signing ANJANETTA FOSTER
BIRMINGHAM FAMILY WELLNESS RETIREMENT TRUST 2019 030498276 2020-07-31 BIRMINGHAM FAMILY WELLNESS 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-09-21
Business code 621111
Sponsor’s telephone number 2057839877
Plan sponsor’s address 652 LOMB AVE SW, BIRMINGHAM, AL, 35211

Signature of

Role Plan administrator
Date 2020-07-31
Name of individual signing ANJANETTA FOSTER
BIRMINGHAM FAMILY WELLNESS RETIREMENT TRUST 2018 030498276 2019-07-31 BIRMINGHAM FAMILY WELLNESS 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-09-21
Business code 621111
Sponsor’s telephone number 2057839877
Plan sponsor’s address 652 LOMB AVE SW, BIRMINGHAM, AL, 35211

Signature of

Role Plan administrator
Date 2019-07-31
Name of individual signing ANJANETTA FOSTER
BIRMINGHAM FAMILY WELLNESS RETIREMENT TRUST 2017 030498276 2018-07-31 BIRMINGHAM FAMILY WELLNESS 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-09-21
Business code 621111
Sponsor’s telephone number 2057839877
Plan sponsor’s address 401 TUSCALOOSA AVE SW, BIRMINGHAM, AL, 35211

Signature of

Role Plan administrator
Date 2018-07-31
Name of individual signing ANJANETTA FOSTER
BIRMINGHAM FAMILY WELLNESS RETIREMENT TRUST 2014 030498276 2015-07-31 BIRMINGHAM FAMILY WELLNESS 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-09-21
Business code 621111
Sponsor’s telephone number 2057839877
Plan sponsor’s address 401 TUSCALOOSA AVE SW, BIRMINGHAM, AL, 35211

Signature of

Role Plan administrator
Date 2015-07-31
Name of individual signing ANJANETTA FOSTER
Role Employer/plan sponsor
Date 2015-07-31
Name of individual signing ANJANETTA FOSTER
BIRMINGHAM FAMILY WELLNESS RETIREMENT TRUST 2013 030498276 2014-10-15 BIRMINGHAM FAMILY WELLNESS 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-09-21
Business code 621111
Sponsor’s telephone number 2057839877
Plan sponsor’s address 401 TUSCALOOSA AVE SW, BIRMINGHAM, AL, 35211

Signature of

Role Plan administrator
Date 2014-10-15
Name of individual signing ANJANETTA FOSTER
Role Employer/plan sponsor
Date 2014-10-15
Name of individual signing ANJANETTA FOSTER

Agent

Name Role
FOSTER, ANJANETTA L Agent

Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State