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  5. Southlake Pediatrics, Inc.

Southlake Pediatrics, Inc.

Details

Name: Southlake Pediatrics, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Exists
Date of registration: 06 Jun 2003 (22 years ago)
Entity Number: 000-229-499
Register Number: 000229499
ZIP code: 35244
County: Jefferson
Place of Formation: Shelby County
Principal Address: BIRMINGHAM, AL
Registered Office Street Address: 4515 SOUTHLAKE PKWYBIRMINGHAM, AL 35244
Authorized Capital: 10,000

Activities PEDIATRIC/ADOLESCENT MEDICINE PRACTICE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTHLAKE PEDIATRICS, INC. 401(K) P/S PLAN 2023 061699122 2024-10-08 SOUTHLAKE PEDIATRICS, INC. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2053834727
Plan sponsor’s address 5000 SLAKE PARK, SUITE 250, BIRMINGHAM, AL, 35244

Signature of
Role Plan administrator
Date 2024-10-08
Name of individual signing ANDREW MCCOWN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-10-08
Name of individual signing ANDREW MCCOWN
Valid signature Filed with authorized/valid electronic signature
SOUTHLAKE PEDIATRICS, INC. 401(K) P/S PLAN 2022 061699122 2023-07-27 SOUTHLAKE PEDIATRICS, INC. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2053834727
Plan sponsor’s address 5000 SOUTHLAKE PARK, SUITE 250, BIRMINGHAM, AL, 35244

Plan administrator’s name and address
Administrator’s EIN 061699122
Plan administrator’s name SOUTHLAKE PEDIATRICS, INC.
Plan administrator’s address 5000 SOUTHLAKE PARK, SUITE 250, BIRMINGHAM, AL, 35244
Administrator’s telephone number 2053834727

Signature of
Role Plan administrator
Date 2023-07-27
Name of individual signing ANDREW MCCOWN
SOUTHLAKE PEDIATRICS, INC. 401(K) P/S PLAN 2021 061699122 2022-07-14 SOUTHLAKE PEDIATRICS, INC. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2053834727
Plan sponsor’s address 5000 SOUTHLAKE PARK, SUITE 250, BIRMINGHAM, AL, 35244

Plan administrator’s name and address
Administrator’s EIN 061699122
Plan administrator’s name SOUTHLAKE PEDIATRICS, INC.
Plan administrator’s address 5000 SOUTHLAKE PARK, SUITE 250, BIRMINGHAM, AL, 35244
Administrator’s telephone number 2053834727

Signature of
Role Plan administrator
Date 2022-07-14
Name of individual signing ANDREW MCCOWN
SOUTHLAKE PEDIATRICS HEALTH AND WELFARE BENEFIT PLAN 2020 061699122 2021-10-11 SOUTHLAKE PEDIATRICS 8
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2020-07-01
Business code 524140
Sponsor’s telephone number 2059822500
Plan sponsor’s address 5000 SOUTHLAKE PARK, SUITE 250, BIRMINGHAM, AL, 35244

Plan administrator’s name and address
Administrator’s EIN 834125247
Plan administrator’s name ARSENAL HEALTH LLC
Plan administrator’s address 5151 HAMPSTEAD HIGH STREET, SUITE 200, MONTGOMERY, AL, 36116

Signature of
Role Plan administrator
Date 2021-10-07
Name of individual signing THOMAS BRITT TAYLOR
SOUTHLAKE PEDIATRICS, INC. 401(K) P/S PLAN 2020 061699122 2021-07-18 SOUTHLAKE PEDIATRICS, INC. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2053834727
Plan sponsor’s address 5000 SOUTHLAKE PARK, SUITE 250, BIRMINGHAM, AL, 35244

Plan administrator’s name and address
Administrator’s EIN 061699122
Plan administrator’s name SOUTHLAKE PEDIATRICS, INC.
Plan administrator’s address 5000 SOUTHLAKE PARK, SUITE 250, BIRMINGHAM, AL, 35244
Administrator’s telephone number 2053834727

Signature of
Role Plan administrator
Date 2021-07-18
Name of individual signing ANDREW MCCOWN
SOUTHLAKE PEDIATRICS, INC. 401(K) P/S PLAN 2019 061699122 2020-07-21 SOUTHLAKE PEDIATRICS, INC. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2053834727
Plan sponsor’s address 5000 SOUTHLAKE PARK, SUITE 250, BIRMINGHAM, AL, 35244

Plan administrator’s name and address
Administrator’s EIN 061699122
Plan administrator’s name SOUTHLAKE PEDIATRICS, INC.
Plan administrator’s address 5000 SOUTHLAKE PARK, SUITE 250, BIRMINGHAM, AL, 35244
Administrator’s telephone number 2053834727

Signature of
Role Plan administrator
Date 2020-07-21
Name of individual signing ANDREW MCCOWN
SOUTHLAKE PEDIATRICS, INC. 401(K) P/S PLAN 2018 061699122 2019-07-22 SOUTHLAKE PEDIATRICS, INC. 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2053834727
Plan sponsor’s address 5000 SOUTHLAKE PARK, SUITE 250, BIRMINGHAM, AL, 35244

Plan administrator’s name and address
Administrator’s EIN 061699122
Plan administrator’s name SOUTHLAKE PEDIATRICS, INC.
Plan administrator’s address 5000 SOUTHLAKE PARK, SUITE 250, BIRMINGHAM, AL, 35244
Administrator’s telephone number 2053834727

Signature of
Role Plan administrator
Date 2019-07-22
Name of individual signing ANDREW MCCOWN
SOUTHLAKE PEDIATRICS, INC. 401(K) P/S PLAN 2017 061699122 2018-07-13 SOUTHLAKE PEDIATRICS, INC. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2053834727
Plan sponsor’s address 5000 SOUTHLAKE PARK, SUITE 250, BIRMINGHAM, AL, 35244

Plan administrator’s name and address
Administrator’s EIN 061699122
Plan administrator’s name SOUTHLAKE PEDIATRICS, INC.
Plan administrator’s address 5000 SOUTHLAKE PARK, SUITE 250, BIRMINGHAM, AL, 35244
Administrator’s telephone number 2053834727

Signature of
Role Plan administrator
Date 2018-07-13
Name of individual signing ANDREW MCCOWN
SOUTHLAKE PEDIATRICS, INC. 401(K) P/S PLAN 2016 061699122 2017-07-06 SOUTHLAKE PEDIATRICS, INC. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2053834727
Plan sponsor’s address 5000 SOUTHLAKE PARK, SUITE 250, BIRMINGHAM, AL, 35244

Plan administrator’s name and address
Administrator’s EIN 061699122
Plan administrator’s name SOUTHLAKE PEDIATRICS, INC.
Plan administrator’s address 5000 SOUTHLAKE PARK, SUITE 250, BIRMINGHAM, AL, 35244
Administrator’s telephone number 2053834727

Signature of
Role Plan administrator
Date 2017-07-06
Name of individual signing ANDREW MCCOWN
SOUTHLAKE PEDIATRICS, INC. 401(K) P/S PLAN 2015 061699122 2016-05-27 SOUTHLAKE PEDIATRICS, INC. 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 2053834727
Plan sponsor’s address 5000 SOUTHLAKE PARK, SUITE 250, BIRMINGHAM, AL, 35244

Plan administrator’s name and address
Administrator’s EIN 061699122
Plan administrator’s name SOUTHLAKE PEDIATRICS, INC.
Plan administrator’s address 5000 SOUTHLAKE PARK, SUITE 250, BIRMINGHAM, AL, 35244
Administrator’s telephone number 2053834727

Signature of
Role Plan administrator
Date 2016-05-27
Name of individual signing ANDREW MCCOWN

Agent

Name Role
MCCOWN, ANDREW N Agent

Incorporator

Name Role
MCCOWN, ANDREW N Incorporator

Related by officers

MCCOWN, ANDREW N

Southlake Pediatric Partners, L.L.C.

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Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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