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WESTSIDE FAMILY MEDICAL CLINIC OF TUPELO LLC

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Company Details

Name: WESTSIDE FAMILY MEDICAL CLINIC OF TUPELO LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Dissolved
Effective Date: 18 Aug 2015 (10 years ago)
Business ID: 1073668
ZIP code: 38801
County: Lee
State of Incorporation: MISSISSIPPI
Principal Office Address: 65 S. Thomas StreetTupelo, MS 38801
Historical names: Thomas Street Medical Clinic

Agent

Name Role Address
Richard Neil Vickers Jr Agent 65 S. Thomas Street, Tupelo, MS 38801

Manager

Name Role Address
Debra W. Hill Manager 1307 Michael Circle, Tupelo, MS 38801

Member

Name Role Address
RICHARD NEIL VICKERS Jr Member 1307 Michael Circle, Tupelo, MS 38801

President

Name Role Address
RICHARD NEIL VICKERS Jr President 1307 Michael Circle, Tupelo, MS 38801

Unique Entity ID

CAGE Code:
84U30
UEI Expiration Date:
2020-06-09

Business Information

Activation Date:
2019-06-10
Initial Registration Date:
2018-07-09

National Provider Identifier

NPI Number:
1427429992

Authorized Person:

Name:
NEIL VICKERS
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
363LP2300X - Primary Care Nurse Practitioner
Is Primary:
Yes

Contacts:

Filings

Type Status Filed Date Description
Dissolution Filed 2022-12-14 Dissolution For WESTSIDE FAMILY MEDICAL CLINIC OF TUPELO LLC
Annual Report LLC Filed 2022-05-20 Annual Report For WESTSIDE FAMILY MEDICAL CLINIC OF TUPELO LLC
Annual Report LLC Filed 2021-03-26 Annual Report For WESTSIDE FAMILY MEDICAL CLINIC OF TUPELO LLC
Annual Report LLC Filed 2020-02-19 Annual Report For WESTSIDE FAMILY MEDICAL CLINIC OF TUPELO LLC
Amendment Form Filed 2019-02-25 Amendment For WESTSIDE FAMILY MEDICAL CLINIC OF TUPELO LLC
Annual Report LLC Filed 2019-02-21 Annual Report For WESTSIDE FAMILY MEDICAL CLINIC OF TUPELO LLC
Fictitious Name Registration Filed 2018-10-10 Fictitious Name Registration For WESTSIDE FAMILY MEDICAL CLINIC OF TUPELO LLC
Annual Report LLC Filed 2018-02-26 Annual Report For WESTSIDE FAMILY MEDICAL CLINIC OF TUPELO LLC
Reinstatement Filed 2017-09-20 Reinstatement For WESTSIDE FAMILY MEDICAL CLINIC OF TUPELO LLC
Admin Dissolution Filed 2016-11-30 Admin Dissolution

USAspending Awards / Financial Assistance

Date:
2020-04-09
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
27600.00
Total Face Value Of Loan:
27600.00

Paycheck Protection Program

Jobs Reported:
5
Initial Approval Amount:
$27,600
Date Approved:
2020-04-09
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$27,600
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$27,789.55
Servicing Lender:
Renasant Bank
Use of Proceeds:
Payroll: $27,600

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Date of last update: 03 Jul 2025

Sources: Company Profile on Mississippi Secretary of State Website