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DELTA MEDICAL FOUNDATION

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Company Details

Name: DELTA MEDICAL FOUNDATION
Jurisdiction: MISSISSIPPI
Business Type: Non Profit Corporation
Status: Good Standing
Effective Date: 13 Feb 2018 (7 years ago)
Business ID: 1139029
ZIP code: 38646
County: Quitman
State of Incorporation: MISSISSIPPI
Principal Office Address: 1022 Martin Luther KingMarks, MS 38646

Agent

Name Role Address
Lonnie Moore Agent 1022 Martin Luther King, Marks, MS 38646

Incorporator

Name Role Address
Jerrad T Howard Incorporator 255 East Fifth Street, Suite 1900, Cincinnati, OH 45202

President

Name Role Address
Robert Paul Long Jr President 1022 Martin Luther King Dr, Marks, MS 38646

Treasurer

Name Role Address
Malcom Self Treasurer 1022 Martin Luther King Dr, Marks, MS 38646

Secretary

Name Role Address
James Craig Gaddy Secretary 1022 Martin Luther King Dr, Marks, MS 38646

Unique Entity ID

A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.

Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity doing business with the federal government must register for a UEI.

Unique Entity ID:
RF3XQ1KWA4R3
CAGE Code:
92E52
UEI Expiration Date:
2026-01-02

Business Information

Division Name:
DELTA MEDICAL FOUNDATION
Activation Date:
2025-01-06
Initial Registration Date:
2021-06-17

National Provider Identifier

NPI Number:
1467949941
Certification Date:
2023-03-01

Authorized Person:

Name:
LONNIE MOORE
Role:
EXECUTIVE DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
261QR1300X - Rural Health Clinic/Center
Is Primary:
No
Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
6623987123
Fax:
6623267077

Form 5500 Series

Employer Identification Number (EIN):
824404269
Plan Year:
2023
Number Of Participants:
33
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
30
Sponsors Telephone Number:

Filings

Type Status Filed Date Description
Non-Profit Annual Report Filed 2025-01-03 Annual Report For DELTA MEDICAL FOUNDATION
Non-Profit Status Report Filed 2024-01-23 Status Report For DELTA MEDICAL FOUNDATION
Amendment Form Filed 2023-03-02 Amendment For DELTA MEDICAL FOUNDATION
Non-Profit Status Report Filed 2023-02-08 Status Report For DELTA MEDICAL FOUNDATION
Non-Profit Status Report Filed 2022-02-11 Status Report For DELTA MEDICAL FOUNDATION
Non-Profit Status Report Filed 2021-02-24 Status Report For DELTA MEDICAL FOUNDATION
Non-Profit Status Report Filed 2020-03-02 Status Report For DELTA MEDICAL FOUNDATION
Non-Profit Status Report Filed 2019-04-04 Status Report For DELTA MEDICAL FOUNDATION
Non-Profit Status Report Filed 2018-12-04 Status Report For DELTA MEDICAL FOUNDATION
Amendment Form Filed 2018-11-19 Amendment For DELTA MEDICAL FOUNDATION

USAspending Awards / Financial Assistance

Date:
2021-07-21
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
RURAL HEALTH CLINIC VACCINE CONFIDENCE PROGRAM
Obligated Amount:
99058.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-04-22
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
10000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00

Tax Exempt

Employer Identification Number (EIN) :
82-4404269
Classification:
Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Ruling Date:
2019-04
National Taxonomy Of Exempt Entities:
Health Care: Ambulatory Health Center, Community Clinic
Deductibility:
Type of organization and use of contribution: A private operating foundation. Deductibility Limitation: 50% (60% for cash contributions)

Determination Letters

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Date of last update: 19 May 2025

Sources: Company Profile on Mississippi Secretary of State Website