| Name: | Hornsby Family Medicine, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 21 Apr 2023 (2 years ago) |
| Entity Number: | 001-075-483 |
| Register Number: | 001075483 |
| County: | Cullman |
| Place of Formation: | Alabama |
| Registered Office Street Address: | 1821 Oxford Dr NWCullman, AL 35057 |
| Registered Office Street Address ZIP Code: | 35057 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467143693 | 2023-05-18 | 2024-01-30 | 214 HIGHWAY 31 NW, HARTSELLE, AL, 356404445, US | 214 HIGHWAY 31 NW, HARTSELLE, AL, 356404445, US | |||||||||||||||||
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| Phone | +1 256-292-7410 |
| Fax | 2565029879 |
| Phone | +1 256-590-4894 |
Authorized person
| Name | DR. JEB STUART HORNSBY |
| Role | OWNER |
| Phone | 2562927410 |
Taxonomy
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | Yes |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HORNSBY FAMILY MEDICINE 401(K) PLAN | 2023 | 923647903 | 2024-07-19 | HORNSBY FAMILY MEDICINE, LLC | 10 | |||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2024-07-19 |
| Name of individual signing | JEB HORNSBY |
| Name | Role |
|---|---|
| Hornsby, Jeb S | Agent |
Date of last update: 17 Aug 2024
Sources: Alabama Secretary of State
