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Family Medical Services, Inc.

Details

Name: Family Medical Services, Inc.
Jurisdiction: Alabama
Legal type: Domestic Non-Profit Corporation
Status: Exists
Date of registration: 01 Jul 1981 (43 years ago) (Companies founded in July 1981)
Entity Number: 000-760-192
Register Number: 000760192
Historical Names: Jefferson Health Foundation, Inc.
ZIP code: 35233 (Companies in Jefferson, 35233)
County: Jefferson
Place of Formation: Jefferson County
Principal Address: BIRMINGHAM, AL
Registered Office Street Address: 1501 5TH AVE SBIRMINGHAM, AL 35233

Activities OPERATION OF MEDICAL FACILITIES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1811600513 2022-12-28 2022-12-28 1640 HWY 78 E, JASPER, AL, 355014034, US 1640 HWY 78 E, JASPER, AL, 355014034, US

Contacts
Phone +1 205-221-3090
Fax 2052213501

Authorized person
Name ROBERT PATRICK DEVEREUX
Role PRESIDENT
Phone 2053057399

Taxonomy
Taxonomy Code 3336L0003X - Long Term Care Pharmacy
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 100002152
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FAMILY MEDICAL SERVICES, INC. 401(K) PROFIT SHARING PLAN 2023 630397832 2024-04-25 FAMILY MEDICAL SERVICES, INC. 19
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1995-07-01
Business code 446110
Sponsor’s telephone number 2054261883
Plan sponsor’s address 1819 13TH AVENUE NORTH, BESSEMER, AL, 350203246

Signature of
Role Plan administrator
Date 2024-04-25
Name of individual signing CATHY SELF
FAMILY MEDICAL SERVICES, INC. 401(K) PROFIT SHARING PLAN 2022 630397832 2023-06-05 FAMILY MEDICAL SERVICES, INC. 32
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1995-07-01
Business code 446110
Sponsor’s telephone number 2054261883
Plan sponsor’s address 1819 13TH AVENUE NORTH, BESSEMER, AL, 350203246

Signature of
Role Plan administrator
Date 2023-06-05
Name of individual signing CATHY SELF
FAMILY MEDICAL SERVICES, INC. 401(K) PROFIT SHARING PLAN 2021 630397832 2022-05-02 FAMILY MEDICAL SERVICES, INC. 34
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1995-07-01
Business code 446110
Sponsor’s telephone number 2054261883
Plan sponsor’s address 1819 13TH AVENUE NORTH, BESSEMER, AL, 350203246

Signature of
Role Plan administrator
Date 2022-05-02
Name of individual signing CATHY SELF
FAMILY MEDICAL SERVICES, INC. 401(K) PROFIT SHARING PLAN 2020 630397832 2021-07-29 FAMILY MEDICAL SERVICES, INC. 37
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1995-07-01
Business code 446110
Sponsor’s telephone number 2054261883
Plan sponsor’s address 1819 13TH AVENUE NORTH, BESSEMER, AL, 350203246

Signature of
Role Plan administrator
Date 2021-07-29
Name of individual signing CATHY SELF
FAMILY MEDICAL SERVICES, INC. 401(K) PROFIT SHARING PLAN 2019 630397832 2020-02-18 FAMILY MEDICAL SERVICES, INC. 34
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1995-07-01
Business code 446110
Sponsor’s telephone number 2054261883
Plan sponsor’s address 1819 13TH AVENUE NORTH, BESSEMER, AL, 350203246

Signature of
Role Plan administrator
Date 2020-02-18
Name of individual signing CATHY SELF
FAMILY MEDICAL SERVICES, INC. 401(K) PROFIT SHARING PLAN 2018 630397832 2019-03-05 FAMILY MEDICAL SERVICES, INC. 31
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1995-07-01
Business code 446110
Sponsor’s telephone number 2054261883
Plan sponsor’s address 1819 13TH AVENUE NORTH, BESSEMER, AL, 350203246

Signature of
Role Plan administrator
Date 2019-03-05
Name of individual signing CATHY SELF
FAMILY MEDICAL SERVICES, INC. 401(K) PROFIT SHARING PLAN 2017 630397832 2018-07-10 FAMILY MEDICAL SERVICES, INC. 29
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1995-07-01
Business code 446110
Sponsor’s telephone number 2054261883
Plan sponsor’s address 1819 13TH AVENUE NORTH, BESSEMER, AL, 350203246

Signature of
Role Plan administrator
Date 2018-07-10
Name of individual signing CATHY SELF
FAMILY MEDICAL SERVICES, INC. 401(K) PROFIT SHARING PLAN 2016 630397832 2017-07-05 FAMILY MEDICAL SERVICES, INC. 30
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1995-07-01
Business code 446110
Sponsor’s telephone number 2054261883
Plan sponsor’s address 1819 13TH AVENUE NORTH, BESSEMER, AL, 350203246

Signature of
Role Plan administrator
Date 2017-07-05
Name of individual signing CATHY SELF
FAMILY MEDICAL SERVICES, INC. 401(K) PROFIT SHARING PLAN 2015 630397832 2016-05-16 FAMILY MEDICAL SERVICES, INC. 32
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1995-07-01
Business code 446110
Sponsor’s telephone number 2054261883
Plan sponsor’s address 1819 13TH AVENUE NORTH, BESSEMER, AL, 350203246

Signature of
Role Plan administrator
Date 2016-05-16
Name of individual signing CATHY SELF
FAMILY MEDICAL SERVICES, INC. 401(K) PROFIT SHARING PLAN 2014 630397832 2015-07-25 FAMILY MEDICAL SERVICES, INC. 33
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1995-07-01
Business code 446110
Sponsor’s telephone number 2054261883
Plan sponsor’s address 1819 13TH AVENUE NORTH, BESSEMER, AL, 350203246

Signature of
Role Plan administrator
Date 2015-07-25
Name of individual signing CATHY SELF

Agent

Name Role
FAUST, JOHN M JR Agent

Incorporator

Name Role
FAUST, JOHN M JR Incorporator
DAVIS, J MASON Incorporator
WEBBER, STEVE Incorporator

Events

Event Date Event Type Old Value New Value
1983-04-15 Name Change Jefferson Health Foundation, Inc. Family Medical Services, Inc.

Related by officers

FAUST, JOHN M JR

Alabama Health Plan, Inc. Family Medical Services Cooperative

DAVIS, J MASON

Acamar Realty and Insurance Agency, Incorporated Alabama Democratic Leadership Council, Inc. Birmingham Downs Association, Inc. Birmingham Downs, Inc. Quality Casualty Insurance Company, Inc. Andre' TV Service, Inc. Birmingham Airport Authority Cable TV, Inc. Jefferson County Committee for Economic Opportunity

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Date of last update: 15 Aug 2024

Sources: Alabama Secretary of State

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