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  5. ALASKA EAR NOSE & THROAT, INC.

ALASKA EAR NOSE & THROAT, INC.

Contents

Company Details

Name: ALASKA EAR NOSE & THROAT, INC.
Jurisdiction: Alaska
Legal type: Professional Corporation
Status: Non-Compliant
Date of registration: 03 Apr 1995 (30 years ago)
Entity Number: 55712D
ZIP code: 99508
County: Anchorage
Place of Formation: ALASKA
Address: 3841 PIPER STREET SUITE T311, ANCHORAGE, AK 99508
Mailing Address: UNITED STATES

Activity

Line of Business

62 Health Care and Social Assistance

NAICS

621111 OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)

Officers

Name Role
JEROME LIST Shareholder
JEROME LIST Director
JEROME LIST President
JEROME LIST Secretary
JEROME LIST Treasurer
SARAH LAMBDIN Registered Agent

Form 5500

Plan Name Plan Year EIN/PN Received Total number of participants
ALASKA EAR, NOSE & THROAT 401(K) PLAN 2023 920154149 2024-09-16 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Sponsor ALASKA EAR, NOSE & THROAT
Business code 621111
Sponsor’s telephone number 9075633096
Plan sponsor’s address 3001 WIDGEON LANE, #7, ANCHORAGE, AK, 99508
ALASKA EAR, NOSE & THROAT 401(K) PLAN 2023 920154149 2024-09-16 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Sponsor ALASKA EAR, NOSE & THROAT
Business code 621111
Sponsor’s telephone number 9075633096
Plan sponsor’s address 3001 WIDGEON LANE, #7, ANCHORAGE, AK, 99508
ALASKA EAR, NOSE & THROAT 401(K) PLAN 2022 920154149 2023-10-03 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Sponsor ALASKA EAR, NOSE & THROAT
Business code 621111
Sponsor’s telephone number 9075633096
Plan sponsor’s address 3841 PIPER STREET, SUITE T311, ANCHORAGE, AK, 99508
ALASKA EAR, NOSE & THROAT 401(K) PLAN 2021 920154149 2022-08-02 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Sponsor ALASKA EAR, NOSE & THROAT
Business code 621111
Sponsor’s telephone number 9075633096
Plan sponsor’s address 3841 PIPER STREET, SUITE T311, ANCHORAGE, AK, 99508
ALASKA EAR NOSE & THROAT 401(K) PLAN 2020 920154149 2021-07-07 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Sponsor ALASKA EAR NOSE & THROAT
Business code 621111
Sponsor’s telephone number 9075633096
Plan sponsor’s address 3841 PIPER ST STE T4-348, ANCHORAGE, AK, 995084674

Signature of
Role Plan administrator
Date 2021-07-07
Name of individual signing ASHLEY LIST
ALASKA EAR NOSE & THROAT 401(K) PLAN 2019 920154149 2020-10-02 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Sponsor ALASKA EAR NOSE & THROAT
Business code 621111
Sponsor’s telephone number 9075633096
Plan sponsor’s address 3841 PIPER ST STE T4-348, ANCHORAGE, AK, 995084674

Signature of
Role Plan administrator
Date 2020-10-02
Name of individual signing ASHLEY LIST
ALASKA EAR NOSE & THROAT 401(K) PLAN 2018 920154149 2019-08-27 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Sponsor ALASKA EAR NOSE & THROAT
Business code 621111
Sponsor’s telephone number 9075633096
Plan sponsor’s address 3841 PIPER ST STE T4-348, ANCHORAGE, AK, 995084674

Signature of
Role Plan administrator
Date 2019-08-27
Name of individual signing SARAH LAMBDIN
ALASKA EAR NOSE & THROAT 401(K) PLAN 2017 920154149 2018-09-10 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Sponsor ALASKA EAR NOSE & THROAT
Business code 621111
Sponsor’s telephone number 9075633096
Plan sponsor’s address 3841 PIPER ST STE T4-348, ANCHORAGE, AK, 995084674

Signature of
Role Plan administrator
Date 2018-09-10
Name of individual signing SARAH LAMBDIN
ALASKA EAR NOSE & THROAT 401(K) PLAN 2016 920154149 2017-07-27 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Sponsor ALASKA EAR NOSE & THROAT
Business code 621111
Sponsor’s telephone number 9075633096
Plan sponsor’s address 3841 PIPER ST STE T4-348, ANCHORAGE, AK, 995084674

Signature of
Role Plan administrator
Date 2017-07-27
Name of individual signing SARAH LAMBDIN
ALASKA EAR NOSE & THROAT 401(K) PLAN 2015 920154149 2016-06-29 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Sponsor ALASKA EAR NOSE & THROAT
Business code 621111
Sponsor’s telephone number 9075633096
Plan sponsor’s address 3841 PIPER ST STE T4-348, ANCHORAGE, AK, 995084674

Signature of
Role Plan administrator
Date 2016-06-29
Name of individual signing JEROME LIST
Role Employer/plan sponsor
Date 2016-06-29
Name of individual signing JEROME LIST

Licenses

Type License Number Status Date of issue Date of renewal Expiration date Description
Business License 279771 Active 2000-11-30 2023-10-04 2024-12-31 LOB: 62 - Health Care and Social Assistance, NAICS: 621111 - OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Telemedicine Business Registry 159809 Active 2020-03-27 - - -

Date of last update: 10 Jan 2025

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

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