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Whatley Health Services, Inc.

Details

Name: Whatley Health Services, Inc.
Jurisdiction: Alabama
Legal type: Domestic Non-Profit Corporation
Status: Exists
Date of registration: 11 Mar 1977 (48 years ago)
Entity Number: 000-811-290
Register Number: 000811290
Historical Names: West Tuscaloosa Community Health Center, Inc.
County: Tuscaloosa
Place of Formation: Tuscaloosa County
Principal Address: TUSCALOOSA, AL
Registered Office Street Address: 2200 JACK WARNER PKWY STE 200TUSCALOOSA, AL 35401
Registered Office Street Address ZIP Code: 35401
Registered Office Mailing Address: PO BOX 2727TUSCALOOSA, AL 35403
Registered Office Mailing Address ZIP Code: 35403

Activities MEDICAL & HEALTH CARE

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
LLKKWKC9GJY7 2025-04-22 2731 ML KING JR BLVD, TUSCALOOSA, AL, 35401, 5235, USA POST OFFICE BOX 2400, TUSCALOOSA, AL, 35403, 2400, USA

Business Information

Congressional District 07
State/Country of Incorporation AL, USA
Activation Date 2024-04-24
Initial Registration Date 2006-03-09
Entity Start Date 1978-10-01
Fiscal Year End Close Date Dec 31

Service Classifications

NAICS Codes 621498
Product and Service Codes Z1DB

Points of Contacts

Electronic Business
Title PRIMARY POC
Name DAVID E GAY
Address 2731 M L KING JR BLVD, TUSCALOOSA, AL, 35401, USA
Title ALTERNATE POC
Name RAJUAN SHERMAN
Address 2731 M L KING JR BLVD, POST OFFICE BOX 2400, TUSCALOOSA, AL, 35401, USA
Government Business
Title PRIMARY POC
Name DAVID E GAY
Address 2731 M L KING JR BLVD, TUSCALOOSA, AL, 35401, USA
Title ALTERNATE POC
Name RAJUAN SHERMAN
Address 2731 M L KING JR BLVD, POST OFFICE BOX 2400, TUSCALOOSA, AL, 35401, USA
Past Performance
Title ALTERNATE POC
Name RAJUAN SHERMAN
Address 2731 M L KING JR BLVD, POST OFFICE BOX 2400, TUSCALOOSA, AL, 35403, USA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1295447787 2022-12-16 2023-01-19 2731 MARTIN LUTHER KING BLVD, TUSCALOOSA, AL, 354015235, US 432 5TH STREET NW, ALICEVILLE, AL, 35442, US

Contacts

Phone +1 205-758-6647

Authorized person

Name DAVID ELLIS GAY
Role CEO
Phone 2053493250

Taxonomy

Taxonomy Code 261QF0400X - Federally Qualified Health Center (FQHC)
Is Primary Yes

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
4BZ08 Active Non-Manufacturer 2006-03-10 2024-05-22 2029-05-22 2025-04-22

Contact Information

POC DAVID E. GAY
Phone +1 205-758-6647
Fax +1 205-750-2154
Address 2731 ML KING JR BLVD, TUSCALOOSA, AL, 35401 5235, UNITED STATES

Ownership of Offeror Information

Highest Level Owner Information not Available
Immediate Level Owner Information not Available
List of Offerors (0) Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SECTION 403(B) RETIREMENT PLAN WHATLEY HEALTH SERVICES, INC. 2023 630727781 2024-08-12 WHATLEY HEALTH SERVICES, INC. 164
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621498
Sponsor’s telephone number 2056146135
Plan sponsor’s address 2731 MARTIN LUTHER KING JR BLV, TUSCALOOSA, AL, 354015235

Signature of

Role Plan administrator
Date 2024-08-12
Name of individual signing DAVID GAY
Role Employer/plan sponsor
Date 2024-08-12
Name of individual signing DAVID GAY

Agent

Name Role Address
TOMPKINS, MATTHEW Q Agent 2200 JACK WARNER PARKWAY, SUITE 200TUSCALOOSA, AL 35401-2003

Incorporator

Name Role
WHATLEY, MAUDE L Incorporator
MCCOY, HENRY Incorporator
CROWELL, REV L C Incorporator

Events

Event Date Event Type Old Value New Value
1994-07-19 Name Change West Tuscaloosa Community Health Center, Inc. Whatley Health Services, Inc.

Date of last update: 16 Aug 2024

Sources: Alabama Secretary of State