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  5. Premier Orthopedic Surgery, Inc.

Premier Orthopedic Surgery, Inc.

Details

Name: Premier Orthopedic Surgery, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Dissolved
Date of registration: 09 Mar 2006 (19 years ago)
Date of dissolution: 05 Mar 2022
Entity Number: 000-246-222
Register Number: 000246222
ZIP code: 35957
County: Marshall
Place of Formation: Marshall County
Principal Address: BOAZ, AL
Registered Office Street Address: 140 NORTH MAIN STBOAZ, AL 35957
Authorized Capital: $1,000

Activities MEDICAL SERVICE

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1205187663 2012-09-26 2012-09-26 7938 AL HWY 69, SUITE 100, GUNTERSVILLE, AL, 359767119, US 2367 US HIGHWAY 431, BOAZ, AL, 359575910, US

Contacts
Phone +1 256-571-8445
Fax 2565718447

Authorized person
Name MATTHEW P SMITH
Role PRESIDENT
Phone 2565718445

Taxonomy
Taxonomy Code 174400000X - Specialist
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 009938489
State AL
Issuer BCBS OF AL
Number 51003891
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PREMIER ORTHOPEDIC SURGERY, INC. 401(K) PLAN 2019 204540503 2020-09-16 PREMIER ORTHOPEDIC SURGERY, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2565718445
Plan sponsor’s address 7938 AL HWY 69 SUITE 100, GUNTERSVILLE, AL, 35976
PREMIER ORTHOPEDIC SURGERY, INC. CASH BALANCE PLAN 2019 204540503 2020-09-16 PREMIER ORTHOPEDIC SURGERY, INC. 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2565718445
Plan sponsor’s address 7938 AL HWY 69 SUITE 100, GUNTERSVILLE, AL, 35976
PREMIER ORTHOPEDIC SURGERY, INC. 401(K) PLAN 2018 204540503 2019-10-11 PREMIER ORTHOPEDIC SURGERY, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2565718445
Plan sponsor’s address 7938 AL HWY 69 SUITE 100, GUNTERSVILLE, AL, 35976
PREMIER ORTHOPEDIC SURGERY, INC. CASH BALANCE PLAN 2018 204540503 2019-10-11 PREMIER ORTHOPEDIC SURGERY, INC. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2565718445
Plan sponsor’s address 7938 AL HWY 69 SUITE 100, GUNTERSVILLE, AL, 35976
PREMIER ORTHOPEDIC SURGERY, INC. CASH BALANCE PLAN 2017 204540503 2018-07-20 PREMIER ORTHOPEDIC SURGERY, INC. 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2565718445
Plan sponsor’s address 7938 AL HWY 69 SUITE 100, GUNTERSVILLE, AL, 35976
PREMIER ORTHOPEDIC SURGERY, INC. 401(K) PLAN 2017 204540503 2018-07-20 PREMIER ORTHOPEDIC SURGERY, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2017-01-01
Business code 621111
Sponsor’s telephone number 2565718445
Plan sponsor’s address 7938 AL HWY 69 SUITE 100, GUNTERSVILLE, AL, 35976

Agent

Name Role Address
MITCHELL, SHANNON Agent 140 NORTH MAIN STREETBOAZ, AL 35957

Incorporator

Name Role
SMITH, MATTHEW P Incorporator

Related by officers

MITCHELL, SHANNON

ALAROUGE, L.L.C. Mystical Industrial Coatings LLC Texaz Grill, LLC Don Alejo Mexican Restaurant, LLC GODOGI Enterprise, LLC GODOGI Properties, LLC GODOGI Company, LLC Sand Mountain Development, LLC Commercial Loans, L.L.C. Sand Mountain Stockyard, LLC

Related by address

BOAZ, AL

B & W Department Store, Inc. Boaz Nursing Home, Inc. Cooper Oil Company, Incorporation Fred King's, Inc. S. J. Otinger, Jr., Construction Company Piggly Wiggly of Boaz, Alabama, Inc. Radio Sand Mountain, Inc. San-Ann Premium Center, Inc. Young Supply Company, Inc. Andrew G. Finlay, Jr. P. C.

140 NORTH MAIN STBOAZ, AL 35957

Outlaw Properties, Inc. D W Post, Inc. Carousel Child Care Center, Inc. Bo Bright Sales, Inc. IguanaBiz.Com Corporation Commercial Loans, L.L.C. Blind Pig Properties, L.L.C. Mitchell Brothers Properties, L.L.C. Entrepreneur Marketing, L.L.C.

Date of last update: 02 Aug 2024

Sources: Alabama Secretary of State

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