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Advanced Imaging of Gadsden, LLC

Details

Name: Advanced Imaging of Gadsden, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 08 Mar 2004 (21 years ago) (Companies founded in March 2004)
Entity Number: 000-698-204
Register Number: 000698204
ZIP code: 35901 (Companies in Etowah, 35901)
County: Etowah
Place of Formation: Etowah County
Principal Address: GADSDEN, AL
Registered Office Street Address: 820 S FOURTH STGADSDEN, AL 35901

Activities PROVIDE OUTPATIENT MEDICAL IMAGING

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1972615581 2006-08-31 2018-06-21 820 SOUTH 4TH STREET, GADSDEN, AL, 359015223, US 820 S 4TH STREET, GADSDEN, AL, 359015223, US

Contacts

Phone +1 256-549-0008
Fax 2565490401

Authorized person

Name DR. KENNON H HAGER
Role OWNER/PHYSICIAN
Phone 2565490008

Taxonomy

Taxonomy Code 2085R0202X - Diagnostic Radiology Physician
License Number 17729
State AL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 529921610
State AL
Issuer MEDICARE RAILROAD
Number DC6981
State AL
Issuer MEDICAID
Number 113978
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
ADVANCED IMAGING OF GADSDEN, INC. 401K PROFIT SHARING PLAN 2022 200658774 2023-08-10 ADVANCED IMAGING OF GADSDEN, LLC 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621498
Sponsor’s telephone number 2565490008
Plan sponsor’s address 820 SOUTH 4TH STREET, GADSDEN, AL, 35901

Plan administrator’s name and address

Administrator’s EIN 721386027
Plan administrator’s name PLANTECH, LLP
Plan administrator’s address 2205 CAHABA VALLEY DRIVE, BIRMINGHAM, AL, 35242
Administrator’s telephone number 2059801603

Signature of

Role Plan administrator
Date 2023-08-10
Name of individual signing JOHN ANSAY
ADVANCED IMAGING OF GADSDEN, INC. CASH BALANCE PLAN 2022 200658774 2023-09-12 ADVANCED IMAGING OF GADSDEN, LLC 30
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2565490008
Plan sponsor’s address 820 S 4TH ST., GADSDEN, AL, 35901

Signature of

Role Plan administrator
Date 2023-09-12
Name of individual signing KENNON HAGER
ADVANCED IMAGING OF GADSDEN, INC. 401K PROFIT SHARING PLAN 2021 200658774 2022-08-19 ADVANCED IMAGING OF GADSDEN, LLC 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2565490008
Plan sponsor’s address 820 SOUTH 4TH STREET, GADSDEN, AL, 35901

Plan administrator’s name and address

Administrator’s EIN 721386027
Plan administrator’s name PLANTECH, LLP
Plan administrator’s address 2205 CAHABA VALLEY DRIVE, BIRMINGHAM, AL, 35242
Administrator’s telephone number 2059801603

Signature of

Role Plan administrator
Date 2022-08-19
Name of individual signing ALYCE RALEY
ADVANCED IMAGING OF GADSDEN, INC. CASH BALANCE PLAN 2021 200658774 2022-08-15 ADVANCED IMAGING OF GADSDEN, LLC 24
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2565490008
Plan sponsor’s address 820 S 4TH ST., GADSDEN, AL, 35901

Signature of

Role Plan administrator
Date 2022-08-15
Name of individual signing KENNON HAGER
ADVANCED IMAGING OF GADSDEN, INC. 401K PROFIT SHARING PLAN 2020 200658774 2021-09-07 ADVANCED IMAGING OF GADSDEN, LLC 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2565490008
Plan sponsor’s address 820 SOUTH 4TH STREET, GADSDEN, AL, 35901

Plan administrator’s name and address

Administrator’s EIN 721386027
Plan administrator’s name PLANTECH, LLP
Plan administrator’s address 2205 CAHABA VALLEY DRIVE, BIRMINGHAM, AL, 35242
Administrator’s telephone number 2059801603

Signature of

Role Plan administrator
Date 2021-09-07
Name of individual signing JOHN ANSAY
ADVANCED IMAGING OF GADSDEN, INC. CASH BALANCE PLAN 2020 200658774 2021-08-24 ADVANCED IMAGING OF GADSDEN, LLC 29
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2565490008
Plan sponsor’s address 820 S 4TH ST., GADSDEN, AL, 35901

Signature of

Role Plan administrator
Date 2021-08-24
Name of individual signing KENNON HAGER
ADVANCED IMAGING OF GADSDEN, INC. 401K PROFIT SHARING PLAN 2019 200658774 2020-08-17 ADVANCED IMAGING OF GADSDEN, LLC 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2565490008
Plan sponsor’s address 820 SOUTH 4TH STREET, GADSDEN, AL, 35901

Plan administrator’s name and address

Administrator’s EIN 721386027
Plan administrator’s name PLANTECH, LLP
Plan administrator’s address 2205 CAHABA VALLEY DRIVE, BIRMINGHAM, AL, 35242
Administrator’s telephone number 2059801603

Signature of

Role Plan administrator
Date 2020-08-17
Name of individual signing KATHY BITTLE
ADVANCED IMAGING OF GADSDEN, INC. CASH BALANCE PLAN 2019 200658774 2020-09-01 ADVANCED IMAGING OF GADSDEN, LLC 31
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2565490008
Plan sponsor’s address 820 S 4TH ST., GADSDEN, AL, 35901

Signature of

Role Plan administrator
Date 2020-09-01
Name of individual signing KENON HAGER
ADVANCED IMAGING OF GADSDEN, INC. CASH BALANCE PLAN 2018 200658774 2019-10-10 ADVANCED IMAGING OF GADSDEN, LLC 34
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2565490008
Plan sponsor’s address 820 S 4TH ST., GADSDEN, AL, 35901

Signature of

Role Plan administrator
Date 2019-10-10
Name of individual signing KENON HAGER
ADVANCED IMAGING OF GADSDEN, INC. 401K PROFIT SHARING PLAN 2018 200658774 2019-10-02 ADVANCED IMAGING OF GADSDEN, LLC 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-01-01
Business code 621111
Sponsor’s telephone number 2565490008
Plan sponsor’s address 820 SOUTH 4TH STREET, GADSDEN, AL, 35901

Plan administrator’s name and address

Administrator’s EIN 721386027
Plan administrator’s name PLANTECH, LLP
Plan administrator’s address 2205 CAHABA VALLEY DRIVE, BIRMINGHAM, AL, 35242
Administrator’s telephone number 2059801603

Signature of

Role Plan administrator
Date 2019-10-02
Name of individual signing KATHY BITTLE

Member

Name Role
HAGER, K H Member

Agent

Name Role
HAGER, K H Agent

Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State