INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
2023
|
020700026
|
2024-07-11
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
64
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2012-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6625340898
|
Plan sponsor’s
address |
118 FAIRFIELD DRIVE, NEW ALBANY, MS, 38652
|
Signature of
Role |
Plan administrator |
Date |
2024-07-11 |
Name of individual signing |
ERIC HARDING, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2024-07-11 |
Name of individual signing |
ERIC HARDING, MD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
2022
|
020700026
|
2023-06-30
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
61
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2012-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6625340898
|
Plan sponsor’s
address |
118 FAIRFIELD DRIVE, NEW ALBANY, MS, 38652
|
Signature of
Role |
Plan administrator |
Date |
2023-06-30 |
Name of individual signing |
KAY WARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2023-06-30 |
Name of individual signing |
ERIC HARDING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
2021
|
020700026
|
2022-06-15
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
55
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2012-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6625340898
|
Plan sponsor’s
address |
118 FAIRFIELD DRIVE, NEW ALBANY, MS, 38652
|
Signature of
Role |
Plan administrator |
Date |
2022-06-09 |
Name of individual signing |
KAY WARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
2020
|
020700026
|
2021-06-02
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
44
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2012-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6625340898
|
Plan sponsor’s
address |
118 FAIRFIELD DRIVE, NEW ALBANY, MS, 38652
|
Signature of
Role |
Plan administrator |
Date |
2021-06-02 |
Name of individual signing |
KAY WARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
2019
|
020700026
|
2020-05-22
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
39
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2012-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6625340898
|
Plan sponsor’s
address |
118 FAIRFIELD DRIVE, NEW ALBANY, MS, 38652
|
Signature of
Role |
Plan administrator |
Date |
2020-05-22 |
Name of individual signing |
KAY WARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2020-05-22 |
Name of individual signing |
ERIC HARDING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
2018
|
020700026
|
2019-06-10
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
28
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2012-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6625340898
|
Plan sponsor’s
address |
118 FAIRFIELD DRIVE, NEW ALBANY, MS, 38652
|
Signature of
Role |
Plan administrator |
Date |
2019-06-10 |
Name of individual signing |
KAY WARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2019-06-10 |
Name of individual signing |
ERIC HARDING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
2017
|
020700026
|
2018-05-18
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
25
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2012-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6625340898
|
Plan sponsor’s
address |
118 FAIRFIELD DRIVE, NEW ALBANY, MS, 38652
|
Signature of
Role |
Plan administrator |
Date |
2018-05-18 |
Name of individual signing |
KAY WARD |
Valid signature |
Filed with authorized/valid electronic signature |
|
Role |
Employer/plan sponsor |
Date |
2018-05-18 |
Name of individual signing |
ERIC HARDING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
2016
|
020700026
|
2017-06-27
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
21
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2012-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6625340898
|
Plan sponsor’s
address |
488 W. BANKHEAD STREET, NEW ALBANY, MS, 38652
|
Signature of
Role |
Plan administrator |
Date |
2017-06-27 |
Name of individual signing |
ERIC HARDING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
2015
|
020700026
|
2016-07-08
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
20
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2012-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6625340898
|
Plan sponsor’s
address |
488 W. BANKHEAD STREET, NEW ALBANY, MS, 38652
|
Signature of
Role |
Plan administrator |
Date |
2016-07-08 |
Name of individual signing |
ERIC HARDING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
2014
|
020700026
|
2015-07-23
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
19
|
|
File |
View Page
|
Three-digit plan number (PN) |
001
|
Effective date of plan |
2012-01-01
|
Business code |
621111
|
Sponsor’s telephone number |
6625340898
|
Plan sponsor’s
address |
488 W. BANKHEAD STREET, NEW ALBANY, MS, 38652
|
Signature of
Role |
Plan administrator |
Date |
2015-07-23 |
Name of individual signing |
ERIC HARDING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
2013
|
020700026
|
2014-06-25
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
28
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2014/06/25/20140625100017P030403616563001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2012-01-01 |
Business code |
621111 |
Sponsor’s telephone number |
6625340898 |
Plan sponsor’s
address |
488 W. BANKHEAD STREET, NEW ALBANY, MS, 38652 |
Signature of
Role |
Plan administrator |
Date |
2014-06-25 |
Name of individual signing |
ERIC HARDING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
2012
|
020700026
|
2013-07-23
|
INTERNAL MEDICINE AND PEDIATRIC CLINIC OF NEW ALBANY, PLLC
|
20
|
|
File |
https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/23/20130723163447P040115814853001.pdf |
Three-digit plan number (PN) |
001 |
Effective date of plan |
2012-01-01 |
Business code |
621111 |
Sponsor’s telephone number |
6625340898 |
Plan sponsor’s
address |
488 W. BANKHEAD STREET, NEW ALBANY, MS, 38652 |
Signature of
Role |
Plan administrator |
Date |
2013-07-23 |
Name of individual signing |
ERIC HARDING |
Valid signature |
Filed with authorized/valid electronic signature |
|
|