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ALLERGY, ASTHMA AND IMMUNOLOGY CENTER OF ALASKA, LLC

Contents

Company Details

Name: ALLERGY, ASTHMA AND IMMUNOLOGY CENTER OF ALASKA, LLC
Jurisdiction: Alaska
Legal type: Limited Liability Company
Status: Good Standing
Date of registration: 31 Dec 2001 (23 years ago)
Entity Number: 75085D
ZIP code: 99508
County: Anchorage
Place of Formation: ALASKA
Address: 3841 PIPER STREET, SUITE T4-054, ANCHORAGE, AK 99508

Activity

Line of Business

62 Health Care and Social Assistance

NAICS

621498 ALL OTHER OUTPATIENT CARE CENTERS

Officers

Name Role
LAURA M. MOORE M.D., P.C. Member
DLG SERVICES, INC. Registered Agent

Form 5500

Plan Name Plan Year EIN/PN Received Total number of participants
ALLERGY, ASTHMA AND IMMUNOLOGY CENTER OF ALASKA, LLC 401(K) PROFIT SHARING PLAN & TRUST 2012 920178082 2013-10-07 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Sponsor ALLERGY, ASTHMA AND IMMUNOLOGY CENTER OF ALASKA, LLC
Business code 621111
Sponsor’s telephone number 9075626228
Plan sponsor’s address 3841 PIPER STREET, SUITE T4-054, ANCHORAGE, AK, 995084673

Signature of

Role Plan administrator
Date 2013-10-07
Name of individual signing EILEEN DEMAIN
Role Employer/plan sponsor
Date 2013-10-07
Name of individual signing EILEEN DEMAIN
ALLERGY, ASTHMA AND IMMUNOLOGY CENTER OF ALASKA, LLC 401(K) PROFIT SHARING PLAN & TRUST 2011 920178082 2012-10-15 40
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Sponsor ALLERGY, ASTHMA AND IMMUNOLOGY CENTER OF ALASKA, LLC
Business code 621111
Sponsor’s telephone number 9075626228
Plan sponsor’s address 3841 PIPER STREET, SUITE T4-054, ANCHORAGE, AK, 995084673

Plan administrator’s name and address

Administrator’s EIN 920178082
Plan administrator’s name ALLERGY, ASTHMA AND IMMUNOLOGY CENTER OF ALASKA, LLC
Plan administrator’s address 3841 PIPER STREET, SUITE T4-054, ANCHORAGE, AK, 995084673
Administrator’s telephone number 9075626228

Signature of

Role Plan administrator
Date 2012-10-15
Name of individual signing EILEEN DEMAIN
Role Employer/plan sponsor
Date 2012-10-15
Name of individual signing EILEEN DEMAIN
ALLERGY, ASTHMA AND IMMUNOLOGY CENTER OF ALASKA, LLC 401(K) PROFIT SHARING PLAN & TRUST 2010 920178082 2011-10-11 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1999-01-01
Sponsor ALLERGY, ASTHMA AND IMMUNOLOGY CENTER OF ALASKA, LLC
Business code 621111
Sponsor’s telephone number 9075626228
Plan sponsor’s address 3841 PIPER STREET, SUITE T4-054, ANCHORAGE, AK, 995084673

Plan administrator’s name and address

Administrator’s EIN 920178082
Plan administrator’s name ALLERGY, ASTHMA AND IMMUNOLOGY CENTER OF ALASKA, LLC
Plan administrator’s address 3841 PIPER STREET, SUITE T4-054, ANCHORAGE, AK, 995084673
Administrator’s telephone number 9075626228

Signature of

Role Plan administrator
Date 2011-10-11
Name of individual signing EILEEN DEMAIN
Role Employer/plan sponsor
Date 2011-10-11
Name of individual signing EILEEN DEMAIN

Licenses

Type License Number Status Date of issue Date of renewal Expiration date Description
Business License 288888 Active 2002-05-10 2023-10-25 2025-12-31 LOB: 62 - Health Care and Social Assistance, NAICS: 621498 - ALL OTHER OUTPATIENT CARE CENTERS
Telemedicine Business Registry 158738 Active 2020-03-12 - - -

Date of last update: 10 Jan 2025

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