| Name: | The Neurological Care Center of Montgomery, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 01 Aug 2000 (24 years ago) |
| Entity Number: | 000-211-575 |
| Register Number: | 000211575 |
| ZIP code: | 36106 |
| County: | Montgomery |
| Place of Formation: | Montgomery County |
| Principal Address: | MONTGOMERY, AL |
| Registered Office Street Address: | 1315 MULBERRY STMONTGOMERY, AL 36106 |
| Authorized Capital: | -0- |
Activities
NEUROLOGICAL CARE FOR THE CITIZENS OF MONTGOMERY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1588855837 | 2007-08-01 | 2007-08-27 | 1315 MULBERRY ST, MONTGOMERY, AL, 361061132, US | 1315 MULBERRY ST, MONTGOMERY, AL, 361061132, US | |||||||||||||||||||||||||
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| Phone | +1 334-262-1113 |
| Fax | 3342625737 |
Authorized person
| Name | DR. ROSA J BELL |
| Role | OWNER |
| Phone | 3342621113 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | 23542 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BCBS |
| Number | 51097992 |
| State | AL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NEUROLOGICAL CARE CENTER OF MONTGOMERY (WELFARE PLAN) | 2022 | 582561843 | 2023-07-27 | NEUROLOGICAL CARE CENTER OF MONTGOMERY | 3 | |||||||||||||||||||||||||||||||||||||
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| Administrator’s EIN | 472506773 |
| Plan administrator’s name | KENNION & CO, LLC |
| Plan administrator’s address | 2828 OLD 280 COURT, SUITE 110, VESTAVIA, AL, 35243 |
| Administrator’s telephone number | 8669665457 |
Signature of
| Role | Plan administrator |
| Date | 2023-07-19 |
| Name of individual signing | W. HAL SHEPHERD |
| Role | Employer/plan sponsor |
| Date | 2023-07-19 |
| Name of individual signing | W. HAL SHEPHERD |
| File | View Page |
| Three-digit plan number (PN) | 951 |
| Effective date of plan | 2020-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3342621113 |
| Plan sponsor’s address | 1315 MULBERRY STREET, MONTGOMERY, AL, 36106 |
Plan administrator’s name and address
| Administrator’s EIN | 472506773 |
| Plan administrator’s name | KENNION & CO, LLC |
| Plan administrator’s address | 2828 OLD 280 COURT, SUITE 110, VESTAVIA, AL, 35243 |
| Administrator’s telephone number | 8669665457 |
Signature of
| Role | Plan administrator |
| Date | 2022-07-20 |
| Name of individual signing | W. HAL SHEPHERD |
| Role | Employer/plan sponsor |
| Date | 2022-07-20 |
| Name of individual signing | W. HAL SHEPHERD |
| File | View Page |
| Three-digit plan number (PN) | 951 |
| Effective date of plan | 2020-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 3342621113 |
| Plan sponsor’s address | 1315 MULBERRY STREET, MONTGOMERY, AL, 36106 |
Plan administrator’s name and address
| Administrator’s EIN | 472506773 |
| Plan administrator’s name | KENNION & CO, LLC |
| Plan administrator’s address | 2828 OLD 280 COURT, SUITE 110, VESTAVIA, AL, 35243 |
| Administrator’s telephone number | 8669665457 |
Signature of
| Role | Plan administrator |
| Date | 2021-07-21 |
| Name of individual signing | W. HAL SHEPHERD |
| Role | Employer/plan sponsor |
| Date | 2021-07-21 |
| Name of individual signing | W. HAL SHEPHERD |
| Name | Role | Address |
|---|---|---|
| BELL, ROSA J | Agent | 1315 MULBERRY STREETMONTGOMERY, AL 36106 |
| Name | Role | Address |
|---|---|---|
| BELL, ROSA J | Incorporator | 1315 MULBERRY STREETMONTGOMERY, AL 36106 |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
