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  5. Keystone Pharmacy Group, LLC

Keystone Pharmacy Group, LLC

Headquarter

Company Details

Name: Keystone Pharmacy Group, LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Dissolved
Effective Date: 30 May 2013 (12 years ago)
Business ID: 1022096
ZIP code: 39110
County: Madison
State of Incorporation: MISSISSIPPI
Principal Office Address: 118 Weisenburger Road, Suite 400Madison, MS 39110
Historical names: Keystone Pharmacy, LLC
Cornerstone Pharmacy, LLC

Links between entities

Type Company Name Company Number State
Headquarter of Keystone Pharmacy Group, LLC, ALABAMA 000-537-719 ALABAMA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KEYSTONE PHARMACY, LLC 401(K) PLAN 2023 461189809 2024-10-04 KEYSTONE PHARMACY, LLC 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 325410
Sponsor’s telephone number 7316934174
Plan sponsor’s address 106 HIGHLAND WAY, SUITE #206, MADISON, MS, 39110

Signature of
Role Plan administrator
Date 2024-10-04
Name of individual signing DEAN SNIDER
Valid signature Filed with authorized/valid electronic signature
KEYSTONE PHARMACY, LLC 401(K) PLAN 2022 461189809 2023-05-30 KEYSTONE PHARMACY, LLC 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 325410
Sponsor’s telephone number 6015941035
Plan sponsor’s address 106 HIGHLAND WAY, SUITE #206, MADISON, MS, 39110

Signature of
Role Plan administrator
Date 2023-05-30
Name of individual signing GINGER IVAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-05-30
Name of individual signing JEFFREY CLARK
Valid signature Filed with authorized/valid electronic signature
KEYSTONE PHARMACY, LLC 401(K) PLAN 2021 461189809 2022-06-10 KEYSTONE PHARMACY, LLC 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 325410
Sponsor’s telephone number 6015941035
Plan sponsor’s address 106 HIGHLAND WAY, SUITE #206, MADISON, MS, 39110

Signature of
Role Plan administrator
Date 2022-06-10
Name of individual signing GINGER IVAN
Valid signature Filed with authorized/valid electronic signature
KEYSTONE PHARMACY, LLC 401(K) PLAN 2020 461189809 2021-07-15 KEYSTONE PHARMACY, LLC 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 325410
Sponsor’s telephone number 6015941035
Plan sponsor’s address 106 HIGHLAND WAY, SUITE #206, MADISON, MS, 39110

Signature of
Role Plan administrator
Date 2021-07-15
Name of individual signing GINGER IVAN
Valid signature Filed with authorized/valid electronic signature
KEYSTONE PHARMACY, LLC 401(K) PLAN 2019 461189809 2020-07-08 KEYSTONE PHARMACY, LLC 27
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 325410
Sponsor’s telephone number 6017079727
Plan sponsor’s address 106 HIGHLAND WAY, SUITE #206, MADISON, MS, 39110

Signature of
Role Plan administrator
Date 2020-07-08
Name of individual signing GINGER IVAN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-07-08
Name of individual signing GINGER IVAN
Valid signature Filed with authorized/valid electronic signature
KEYSTONE PHARMACY, LLC 401(K) PLAN 2018 461189809 2019-07-08 KEYSTONE PHARMACY, LLC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 325410
Sponsor’s telephone number 6017079727
Plan sponsor’s address 106 HIGHLAND WAY, SUITE #206, MADISON, MS, 39110

Signature of
Role Plan administrator
Date 2019-07-08
Name of individual signing GINGER IVAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Clark, Kelly Agent 118 Wisenburger Road, Madison, MS 39110

Member

Name Role Address
Jeffrey S. Clark Member 118 Weisenburger Road, Suite 400, Madison, MS 39110
Kelly Clark Member 118 Weisenburger Road, Suite 400, Madison, MS 39110

Filings

Type Status Filed Date Description
Admin Dissolution Filed 2015-12-08 Admin Dissolution: AR
Notice to Dissolve/Revoke Filed 2015-09-16 Notice to Dissolve/Revoke
Annual Report LLC Filed 2014-11-03 Annual Report For Keystone Pharmacy Group, LLC
Notice to Dissolve/Revoke Filed 2014-10-13 Notice to Dissolve/Revoke
Amendment Form Filed 2013-09-04 Amendment
Amendment Form Filed 2013-08-08 Amendment
Amendment Form Filed 2013-07-15 Amendment
Amendment Form Filed 2013-06-10 Amendment
Formation Form Filed 2013-05-30 Formation

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
2162358308 2021-01-20 0470 PPS 106 Highland Way Ste 206, Madison, MS, 39110-6930
Loan Status Date 2021-07-09
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 408937.5
Loan Approval Amount (current) 408937.5
Undisbursed Amount 0
Franchise Name -
Lender Location ID 39217
Servicing Lender Name Community Bank of Mississippi
Servicing Lender Address 1905, Community Bank Way, Flowood, MS, 39232
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Madison, MADISON, MS, 39110-6930
Project Congressional District MS-03
Number of Employees 26
NAICS code 446110
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 39217
Originating Lender Name Community Bank of Mississippi
Originating Lender Address Flowood, MS
Gender Female Owned
Veteran Non-Veteran
Forgiveness Amount 410550.84
Forgiveness Paid Date 2021-06-15
4778387002 2020-04-04 0470 PPP 106 HIGHLAND WAY, MADISON, MS, 39110-6915
Loan Status Date 2021-01-07
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 408900
Loan Approval Amount (current) 408900
Undisbursed Amount 0
Franchise Name -
Lender Location ID 39217
Servicing Lender Name Community Bank of Mississippi
Servicing Lender Address 1905, Community Bank Way, Flowood, MS, 39232
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address MADISON, MADISON, MS, 39110-6915
Project Congressional District MS-03
Number of Employees 26
NAICS code 446110
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 39217
Originating Lender Name Community Bank of Mississippi
Originating Lender Address Flowood, MS
Gender Female Owned
Veteran Non-Veteran
Forgiveness Amount 411857.52
Forgiveness Paid Date 2020-12-31

Related by officers

Jeffrey S. Clark

Clark Holding, Inc.

Kelly Clark

Mars Hill Church

Related by address

No related companies by address

Date of last update: 27 Mar 2025

Sources: Mississippi Secretary of State

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