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  5. Spine Care Specialists of Alaska, LLC

Spine Care Specialists of Alaska, LLC

Contents

Company Details

Name: Spine Care Specialists of Alaska, LLC
Jurisdiction: Alaska
Legal type: Limited Liability Company
Status: Good Standing
Date of registration: 04 Oct 2012 (12 years ago)
Entity Number: 10007713
ZIP code: 99709
County: Fairbanks North Star
Place of Formation: ALASKA
Address: 2310 PEGER ROAD, SUITE 104, FAIRBANKS, AK 99709

Activity

Line of Business

62 Health Care and Social Assistance

NAICS

621111 OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)

Officers

Name Role
JOHN LOPEZ Registered Agent
John Lopez Manager
John Lopez Member

Form 5500

Plan Name Plan Year EIN/PN Received Total number of participants
SPINE CARE SPECIALISTS OF ALASKA 401(K) PLAN 2023 461237566 2024-07-08 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Sponsor SPINE CARE SPECIALISTS OF ALASKA, LLC
Business code 621111
Sponsor’s telephone number 9074563876
Plan sponsor’s address 2310 PEGER ROAD, SUITE 104, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2024-07-08
Name of individual signing DESIREE LUNDE
SPINE CARE SPECIALISTS OF ALASKA 401(K) PLAN 2022 461237566 2023-09-27 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Sponsor SPINE CARE SPECIALISTS OF ALASKA, LLC
Business code 621111
Sponsor’s telephone number 9074563876
Plan sponsor’s address 2310 PEGER ROAD, SUITE 106, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2023-09-27
Name of individual signing DESIREE LUNDE
SPINE CARE SPECIALISTS OF ALASKA 401(K) PLAN 2021 461237566 2022-06-03 17
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Sponsor SPINE CARE SPECIALISTS OF ALASKA, LLC
Business code 621111
Sponsor’s telephone number 9074563963
Plan sponsor’s address 2310 PEGER ROAD, SUITE 106, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2022-06-02
Name of individual signing DESIREE LUNDE
Role Employer/plan sponsor
Date 2022-06-02
Name of individual signing JOHN LOPEZ
SPINE CARE SPECIALISTS OF ALASKA 401(K) PLAN 2020 461237566 2021-05-13 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Sponsor SPINE CARE SPECIALISTS OF ALASKA, LLC
Business code 621111
Sponsor’s telephone number 9074563963
Plan sponsor’s address 2310 PEGER ROAD, SUITE 106, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2021-05-13
Name of individual signing DESIREE LUNDE
Role Employer/plan sponsor
Date 2021-05-13
Name of individual signing JOHN LOPEZ
SPINE CARE SPECIALISTS OF ALASKA 401(K) PLAN 2019 461237566 2020-04-29 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Sponsor SPINE CARE SPECIALISTS OF ALASKA, LLC
Business code 621111
Sponsor’s telephone number 9074563963
Plan sponsor’s address 2310 PEGER ROAD, SUITE 106, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2020-04-29
Name of individual signing DESIREE LUNDE
Role Employer/plan sponsor
Date 2020-04-29
Name of individual signing DESIREE LUNDE
SPINE CARE SPECIALISTS OF ALASKA 401(K) PLAN 2018 461237566 2019-05-01 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Sponsor SPINE CARE SPECIALISTS OF ALASKA, LLC
Business code 621111
Sponsor’s telephone number 9074563963
Plan sponsor’s address 2310 PEGER ROAD, SUITE 106, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2019-05-01
Name of individual signing DESIREE LUNDE
Role Employer/plan sponsor
Date 2019-05-01
Name of individual signing DESIREE LUNDE
SPINE CARE SPECIALISTS OF ALASKA 401(K) PLAN 2017 461237566 2018-06-05 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Sponsor SPINE CARE SPECIALISTS OF ALASKA, LLC
Business code 621111
Sponsor’s telephone number 9074563963
Plan sponsor’s address 2310 PEGER ROAD, SUITE 106, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2018-06-05
Name of individual signing DESIREE LUNDE
SPINE CARE SPECIALISTS OF ALASKA 401(K) PLAN 2016 461237566 2017-08-25 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Sponsor SPINE CARE SPECIALISTS OF ALASKA, LLC
Business code 621111
Sponsor’s telephone number 9074521377
Plan sponsor’s address 2310 PEGER ROAD, SUITE 106, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2017-08-25
Name of individual signing DEBRA L JENSEN
SPINE CARE SPECIALISTS OF ALASKA 401(K) PLAN 2015 461237566 2016-08-22 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Sponsor SPINE CARE SPECIALISTS OF ALASKA, LLC
Business code 621111
Sponsor’s telephone number 9074521377
Plan sponsor’s address 2310 PEGER ROAD, SUITE 106, FAIRBANKS, AK, 99709

Signature of
Role Plan administrator
Date 2016-08-22
Name of individual signing DEBRA L JENSEN

Licenses

Type License Number Status Date of issue Date of renewal Expiration date Description
Business License 980124 Active 2012-10-09 2022-10-03 2024-12-31 LOB: 62 - Health Care and Social Assistance, NAICS: 621111 - OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Telemedicine Business Registry 160139 Active 2020-04-02 - - -
Telemedicine Business Registry 160141 Active 2020-04-02 - - -

Date of last update: 10 Jan 2025

Sources: State of Alaska - Department of Commerce, Community, and Economic Development

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