| Name: | PROVIDENCE ANCHORAGE ANESTHESIA MEDICAL GROUP, P.C. |
| Jurisdiction: | Alaska |
| Legal type: | Professional Corporation |
| Status: | Good Standing |
| Date of registration: | 14 Oct 1992 (32 years ago) |
| Entity Number: | 50409D |
| ZIP code: | 99508 |
| County: | Anchorage |
| Place of Formation: | ALASKA |
| Address: | 3300 PROVIDENCE DR STE 207, ANCHORAGE, AK 99508 |
| Name | Role |
|---|---|
| JONATHAN HARRIS | Shareholder |
| DALE GROSS | President |
| CHRISTY LE | Treasurer |
| STEVEN SIVILS | Shareholder |
| STEVEN SIVILS | Director |
| STEVEN SIVILS | Secretary |
| BARBARA CHEN | Shareholder |
| BARBARA CHEN | Vice President |
| BRIAN CHEN | Shareholder |
| BRIAN CHEN | Vice President |
| CIK number | Mailing Address | Business Address | Phone | |
|---|---|---|---|---|
| 1779461 | 3300 PROVIDENCE DRIVE, SUITE 207, ANCHORAGE, AK, 99508 | 3300 PROVIDENCE DRIVE, SUITE 207, ANCHORAGE, AK, 99508 | (907) 561-0027 | |
| Plan Name | Plan Year | EIN/PN | Received | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PROVIDENCE ANCHORAGE ANESTHESIA MEDICAL GROUP, P.C. 401(K) PROFIT SHARING PLAN | 2011 | 920142958 | 2012-04-24 | 36 | |||||||||||||||||||||||||||||||
|
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| Administrator’s EIN | 920142958 |
| Plan administrator’s name | PROVIDENCE ANCHORAGE ANESTHESIA MEDICAL GROUP, P.C. |
| Plan administrator’s address | 3300 PROVIDENCE DRIVE, SUITE 207, ANCHORAGE, AK, 995084619 |
| Administrator’s telephone number | 9075610005 |
Signature of
| Role | Plan administrator |
| Date | 2012-04-24 |
| Name of individual signing | ROBERT PEASE, M.D. |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1993-01-01 |
| Sponsor | PROVIDENCE ANCHORAGE ANESTHESIA MEDICAL GROUP, P.C. |
| Business code | 621111 |
| Sponsor’s telephone number | 9075610005 |
| Plan sponsor’s address | 3300 PROVIDENCE DRIVE, SUITE 207, ANCHORAGE, AK, 995084619 |
Plan administrator’s name and address
| Administrator’s EIN | 920142958 |
| Plan administrator’s name | PROVIDENCE ANCHORAGE ANESTHESIA MEDICAL GROUP, P.C. |
| Plan administrator’s address | 3300 PROVIDENCE DRIVE, SUITE 207, ANCHORAGE, AK, 995084619 |
| Administrator’s telephone number | 9075610005 |
Signature of
| Role | Plan administrator |
| Date | 2011-05-03 |
| Name of individual signing | ROBERT PEASE, M.D. |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1993-01-01 |
| Sponsor | PROVIDENCE ANCHORAGE ANESTHESIA MEDICAL GROUP, P.C. |
| Business code | 621111 |
| Sponsor’s telephone number | 9075610005 |
| Plan sponsor’s address | 3300 PROVIDENCE DRIVE, SUITE 207, ANCHORAGE, AK, 995084619 |
Plan administrator’s name and address
| Administrator’s EIN | 920142958 |
| Plan administrator’s name | PROVIDENCE ANCHORAGE ANESTHESIA MEDICAL GROUP, P.C. |
| Plan administrator’s address | 3300 PROVIDENCE DRIVE, SUITE 207, ANCHORAGE, AK, 995084619 |
| Administrator’s telephone number | 9075610005 |
Signature of
| Role | Plan administrator |
| Date | 2010-07-31 |
| Name of individual signing | JEFF D. WILLIAMS |
Date of last update: 10 Jan 2025
Sources: State of Alaska - Department of Commerce, Community, and Economic Development
