| Name: | Juneau Spine and Pain Center LLC |
| Jurisdiction: | Alaska |
| Legal type: | Limited Liability Company |
| Status: | Good Standing |
| Date of registration: | 26 Nov 2009 (15 years ago) |
| Entity Number: | 125103 |
| ZIP code: | 99801 |
| County: | Juneau |
| Place of Formation: | ALASKA |
| Address: | 3200 HOSPITAL DRIVE SUITE 100, SUITE 100, JUNEAU, AK 99801 |
| Mailing Address: | 3200 HOSPITAL DRIVE, SUITE 100, JUNEAU, AK 99801 |
| Name | Role |
|---|---|
| Marco Wen | Member |
| John Bursell | Member |
| John Bursell | Registered Agent |
| Plan Name | Plan Year | EIN/PN | Received | Total number of participants | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JUNEAU SPINE AND PAIN CENTER, LLC | 2012 | 271378179 | 2013-07-17 | 11 | |||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||
| Role | Plan administrator |
| Date | 2013-07-17 |
| Name of individual signing | MARCO WEN |
| Role | Employer/plan sponsor |
| Date | 2013-07-17 |
| Name of individual signing | MARCO WEN |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2011-04-01 |
| Sponsor | JUNEAU SPINE AND PAIN CENTER, LLC |
| Business code | 541600 |
| Sponsor’s telephone number | 9075235962 |
| Plan sponsor’s address | 3200 HOSPITAL DRIVE, SUITE 100, JUNEAU, AK, 99801 |
Plan administrator’s name and address
| Administrator’s EIN | 271378179 |
| Plan administrator’s name | JUNEAU SPINE AND PAIN CENTER, LLC |
| Plan administrator’s address | 3200 HOSPITAL DRIVE, SUITE 100, JUNEAU, AK, 99801 |
| Administrator’s telephone number | 9075235962 |
Signature of
| Role | Plan administrator |
| Date | 2012-07-19 |
| Name of individual signing | TONYA ISTURIS |
| Role | Employer/plan sponsor |
| Date | 2012-07-19 |
| Name of individual signing | TONYA ISTURIS |
| Type | License Number | Status | Date of issue | Date of renewal | Expiration date | Description |
|---|---|---|---|---|---|---|
| Drug Room | 169598 | Active | 2020-11-19 | - | 2026-06-30 | - |
Date of last update: 10 Jan 2025
Sources: State of Alaska - Department of Commerce, Community, and Economic Development
