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  5. Excel Internal Medicine, Inc.

Excel Internal Medicine, Inc.

Details

Name: Excel Internal Medicine, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Dissolved
Date of registration: 16 Oct 2003 (21 years ago)
Date of dissolution: 16 Sep 2024
Entity Number: 000-231-643
Register Number: 000231643
ZIP code: 35023
County: Jefferson
Place of Formation: Jefferson County
Principal Address: BESSEMER, AL
Registered Office Street Address: 7228 SILVER BELL CIRBESSEMER, AL 35023
Authorized Capital: $1,000

Activities PROVIDE INTERNAL MEDICINE SERVICES

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1538115563 2006-05-25 2020-08-22 513 BROOKWOOD BLVD, SUITE 502, BIRMINGHAM, AL, 352096862, US 513 BROOKWOOD BLVD, SUITE 502, BIRMINGHAM, AL, 352096862, US

Contacts
Phone +1 205-802-6773
Fax 2058719647

Authorized person
Name HANSY ODI
Role OFFICE ADMINISTRATOR
Phone 2058026773

Taxonomy
Taxonomy Code 207R00000X - Internal Medicine Physician
License Number 00024167
State AL
Is Primary Yes

Other Provider Identifiers
Issuer RAILROAD MEDICARE
Number P00086293
State AL
Issuer BCBS OF ALABAMA
Number 51518288
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EXCEL INTERNAL MEDICINE, INC. 401(K) PLAN 2023 364541357 2024-03-26 EXCEL INTERNAL MEDICINE, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2058026773
Plan sponsor’s address 513 BROOKWOOD BLVD., SUITE 502, BIRMINGHAM, AL, 35209

Signature of
Role Plan administrator
Date 2024-03-26
Name of individual signing HANSATU ODI
EXCEL INTERNAL MEDICINE, INC. 401(K) PLAN 2022 364541357 2023-06-07 EXCEL INTERNAL MEDICINE, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2058026773
Plan sponsor’s address 513 BROOKWOOD BLVD., SUITE 502, BIRMINGHAM, AL, 35209

Signature of
Role Plan administrator
Date 2023-06-07
Name of individual signing HANSATU ODI
EXCEL INTERNAL MEDICINE, INC. 401(K) PLAN 2021 364541357 2022-04-20 EXCEL INTERNAL MEDICINE, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2058026773
Plan sponsor’s address 513 BROOKWOOD BLVD., SUITE 502, BIRMINGHAM, AL, 35209

Signature of
Role Plan administrator
Date 2022-04-20
Name of individual signing HANSATU ODI
EXCEL INTERNAL MEDICINE, INC. 401(K) PLAN 2020 364541357 2021-06-30 EXCEL INTERNAL MEDICINE, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2058026773
Plan sponsor’s address 513 BROOKWOOD BLVD. STE 502, BIRMINGHAM, AL, 35209

Signature of
Role Plan administrator
Date 2021-06-30
Name of individual signing HANSATU ODI
Role Employer/plan sponsor
Date 2021-06-30
Name of individual signing HANSATU ODI
EXCEL INTERNAL MEDICINE, INC. 401(K) PLAN 2019 364541357 2020-04-29 EXCEL INTERNAL MEDICINE, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2058026773
Plan sponsor’s address 513 BROOKWOOD BLVD. STE 502, BIRMINGHAM, AL, 35209

Signature of
Role Plan administrator
Date 2020-04-29
Name of individual signing HANSATU ODI
Role Employer/plan sponsor
Date 2020-04-29
Name of individual signing HANSATU ODI
EXCEL INTERNAL MEDICINE, INC. 401(K) PLAN 2018 364541357 2019-04-08 EXCEL INTERNAL MEDICINE, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2058026773
Plan sponsor’s address 513 BROOKWOOD BLVD. STE 502, BIRMINGHAM, AL, 35209

Signature of
Role Plan administrator
Date 2019-04-08
Name of individual signing HANSATU ODI
Role Employer/plan sponsor
Date 2019-04-08
Name of individual signing HANSATU ODI
EXCEL INTERNAL MEDICINE, INC. 401(K) PLAN 2017 364541357 2018-04-16 EXCEL INTERNAL MEDICINE, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2058026773
Plan sponsor’s address 513 BROOKWOOD BLVD. STE 502, BIRMINGHAM, AL, 35209

Signature of
Role Plan administrator
Date 2018-04-16
Name of individual signing HANSATU ODI
Role Employer/plan sponsor
Date 2018-04-16
Name of individual signing HANSATU ODI
EXCEL INTERNAL MEDICINE, INC. 401(K) PLAN 2016 364541357 2017-04-26 EXCEL INTERNAL MEDICINE, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2058026773
Plan sponsor’s address 513 BROOKWOOD BLVD. STE 502, BIRMINGHAM, AL, 35209

Signature of
Role Plan administrator
Date 2017-04-26
Name of individual signing HANSATU ODI
Role Employer/plan sponsor
Date 2017-04-26
Name of individual signing HANSATU ODI
EXCEL INTERNAL MEDICINE, INC. 401(K) PLAN 2015 364541357 2016-04-26 EXCEL INTERNAL MEDICINE, INC. 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2058026773
Plan sponsor’s address 513 BROOKWOOD BLVD. STE 502, BIRMINGHAM, AL, 35209

Signature of
Role Plan administrator
Date 2016-04-26
Name of individual signing HANSATU ODI
EXCEL INTERNAL MEDICINE, INC. 401(K) PLAN 2014 364541357 2015-03-23 EXCEL INTERNAL MEDICINE, INC. 7
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 2058026773
Plan sponsor’s address 513 BROOKWOOD BLVD. STE 502, BIRMINGHAM, AL, 35209

Signature of
Role Plan administrator
Date 2015-03-19
Name of individual signing HANSATU ODI

Agent

Name Role
ODI, EMMANUEL O Agent

Incorporator

Name Role
ODI, EMMANUEL O Incorporator

Related by officers

No related officers

Related by address

BESSEMER, AL

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Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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