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  5. Mednet West, Inc.

Mednet West, Inc.

Details

Name: Mednet West, Inc.
Jurisdiction: Alabama
Legal type: Domestic Non-Profit Corporation
Status: Merged
Date of registration: 26 Jan 2011 (14 years ago)
Entity Number: 000-001-272
Register Number: 000001272
ZIP code: 35401
County: Tuscaloosa
Place of Formation: Tuscaloosa County
Registered Office Street Address: 2731 MARTIN LUTHER KING BLVDTUSCALOOSA, AL 35401

Activities PROVIDE MEDICAL HOME FOR PATIENTS

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1881086890 2015-02-27 2015-02-27 3816 PALISADES DR STE B, TUSCALOOSA, AL, 354053451, US 3816 PALISADES DR STE B, TUSCALOOSA, AL, 354053451, US

Contacts
Phone +1 205-553-4661
Fax 2055532191

Authorized person
Name TINA STEVENSON
Role EXECUTIVE DIRECTOR
Phone 2055534661

Taxonomy
Taxonomy Code 251B00000X - Case Management Agency
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MEDNET WEST, INC. 403(B) PLAN 2017 274701582 2018-09-04 MEDNET WEST, INC. 2
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-06-01
Business code 621399
Sponsor’s telephone number 2055534661
Plan sponsor’s address 3901 GREENSBORO AVENUE, TUSCALOOSA, AL, 35405

Signature of
Role Plan administrator
Date 2018-09-04
Name of individual signing AUSTIN BUTLER
MEDNET WEST, INC. 403(B) PLAN 2016 274701582 2019-11-07 MEDNET WEST, INC. 30
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-06-01
Business code 621399
Sponsor’s telephone number 2055534661
Plan sponsor’s address 3816 PALISADES DRIVE STE B, TUSCALOOSA, AL, 35405

Signature of
Role Plan administrator
Date 2019-11-07
Name of individual signing AUSTIN BUTLER
Role Employer/plan sponsor
Date 2019-11-07
Name of individual signing AUSTIN BUTLER
MEDNET WEST, INC. 403(B) PLAN 2016 274701582 2017-06-27 MEDNET WEST, INC. 30
Three-digit plan number (PN) 001
Effective date of plan 2013-06-01
Business code 621399
Sponsor’s telephone number 2055534661
Plan sponsor’s address 3816 PALISADES DRIVE STE B, TUSCALOOSA, AL, 35405

Signature of
Role Plan administrator
Date 2017-06-27
Name of individual signing AUSTIN BUTLER
MEDNET WEST, INC. 403(B) PLAN 2015 274701582 2016-08-01 MEDNET WEST, INC. 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-06-01
Business code 621399
Sponsor’s telephone number 2055534661
Plan sponsor’s address 3816 PALISADES DRIVE STE B, TUSCALOOSA, AL, 35405

Signature of
Role Plan administrator
Date 2016-08-01
Name of individual signing AUSTIN BUTLER
MEDNET WEST, INC. 403(B) PLAN 2014 274701582 2016-08-15 MEDNET WEST, INC. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-06-01
Business code 624100
Sponsor’s telephone number 2055534661
Plan sponsor’s address 3816 PALISADES DRIVE STE B, TUSCALOOSA, AL, 35405

Signature of
Role Plan administrator
Date 2016-08-15
Name of individual signing AUSTIN BUTLER
MEDNET WEST, INC. 403(B) PLAN 2014 274701582 2016-08-01 MEDNET WEST, INC. 22
Three-digit plan number (PN) 001
Effective date of plan 2013-06-01
Business code 624100
Sponsor’s telephone number 2055534661
Plan sponsor’s address 3816 PALISADES DRIVE STE B, TUSCALOOSA, AL, 35405

Signature of
Role Plan administrator
Date 2016-08-01
Name of individual signing AUSTIN BUTLER
MEDNET WEST, INC. 403(B) PLAN 2013 274701582 2014-10-06 MEDNET WEST, INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-06-01
Business code 624100
Sponsor’s telephone number 2055534661
Plan sponsor’s address 3816 PALISADES DRIVE STE B, TUSCALOOSA, AL, 35405

Signature of
Role Plan administrator
Date 2014-10-06
Name of individual signing AUSTIN BUTLER

Agent

Name Role
TUCKER, DEBORAH H DEBORAH H DEB Agent

Director

Name Role Address
TUCKER, DEBORAH Director 3816 PALISADES DRIVETUSCALOOSA, AL 35405-3451
CULPEPPER, LUCY N Director 3816 PALISADES DRIVETUSCALOOSA, AL 35405-3451
SCOTT, VERNON Director 3816 PALISADES DRIVETUSCALOOSA, AL 35405-3451
BURTON, CYNTHIA W Director 601 BLACK BEARS WAYTUSCALOOSA, AL 35401
WHITE, ALBERT Director 3816 PALISADES DRIVETUSCALOOSA, AL 35405-3451

Incorporator

Name Role Address
JONES, WILLIAM A Incorporator 960 KINGSWAY DRIVEANNISTON, AL 36207

Related by officers

TUCKER, DEBORAH

Alabama Healthcare Consortium, LLC

SCOTT, VERNON

Clanton Twin Theatres, Inc. Diaspora, Inc. West Alabama Medical Association, Inc.

BURTON, CYNTHIA W

Hurricane Creek Trace, Ltd. Community Service Programs of West Alabama, Inc. John England Manor, Ltd. Tuscaloosa County Community Punishment and Corrections Authority Preston Place, LTD West Alabama United Appeal Fund, Inc.

JONES, WILLIAM A

BODY WORKS SALON AND BOUTIQUE, LLC BLACK WARRIOR RETRIEVER CLUB, INC. PWR, LLC GENERATOR PRODUCTIONS RECORDS L.L.C. J & W Builders, Inc. PC Fitness, Inc. Dade Ice Ventures, Inc. Coral Decorative Products, Inc. 3D Medical ExFix, Inc. Tuscaloosa County Bar Association, Inc.

WHITE, ALBERT

Lone Star Enterprise, L.L.C.

Related by address

2731 MARTIN LUTHER KING BLVDTUSCALOOSA, AL 35401

The Maude L. Whatley Foundation Alabama Healthcare Consortium, LLC

Date of last update: 29 Jul 2024

Sources: Alabama Secretary of State

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