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FHS Provider Services, Inc.

Company Details

Name: FHS Provider Services, Inc.
Jurisdiction: MISSISSIPPI
Business Type: Non Profit Corporation
Status: Good Standing
Effective Date: 24 Jul 2018 (7 years ago)
Business ID: 1152564
ZIP code: 39631
County: Wilkinson
State of Incorporation: MISSISSIPPI
Principal Office Address: 178 Hwy 24eCentreville, MS 39631

Incorporator

Name Role Address
Brad Dillard Incorporator 105 S. Front St., Tupelo, MS 38804

President

Name Role Address
Richard Williams President 178 Hwy 24 East, Centreville, MS 39631

Agent

Name Role Address
Brad Dillard Agent 105 S. Front St., Tupelo, MS 38804

Filings

Type Status Filed Date Description
Non-Profit Annual Report Filed 2025-03-12 Annual Report For FHS Provider Services, Inc.
Amendment Form Filed 2022-04-04 Amendment For FHS Provider Services, Inc.
Restate Articles of Incorporation Filed 2020-03-26 Restatement For FHS Provider Services, Inc.
Formation Form Filed 2018-07-24 Formation For FHS Provider Services, Inc.

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
83-1369177 Corporation Unconditional Exemption 178 MS-24, CENTREVILLE, MS, 39631-0000 2022-03
In Care of Name % RICHARD WILLIAMS
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
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)
Deductibility Contributions are deductible.
Foundation 509(a)(3) Type I
Tax Period 2023-09
Asset 1 to 9,999
Income 1,000,000 to 4,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Sep
Asset Amount 2500
Income Amount 2462918
Form 990 Revenue Amount 2462918
National Taxonomy of Exempt Entities Health Care: Health Support Services
Sort Name -

Publication 78 Data

Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A Type I, Type II, or functionally integrated Type III supporting organization. Deductibility Limitation: 50% (60% for cash contributions)

Auto-Revocation List

Description Organizations whose federal tax exempt status was automatically revoked for not filing a Form 990-series return or notice for three consecutive years. Important note: Just because an organization appears on this list, it does not mean the organization is currently revoked, as they may have been reinstated.
Exemption Type 501(c)(3): Religious, educational, charitable, scientific, literary, testing for public safety, fostering national or international amateur sports competition, or prevention of cruelty to children or animals organizations
Revocation Date 2021-02-15
Revocation Posting Date 2021-05-10

Determination Letter

Final Letter(s) FinalLetter_83-1369177_FHSPROVIDERSERVICESINC_05282020_00.tif
FinalLetter_83-1369177_FHSPROVIDERSERVICESINC_05282020.tif
FinalLetter_83-1369177_FHSPROVIDERSERVICESINC_07082021_00.tif

Copies of Returns (990, 990-EZ, 990-PF, 990-T)

Organization Name FHS PROVIDER SERVICES INC
EIN 83-1369177
Tax Period 202109
Filing Type E
Return Type 990
File View File
Organization Name FHS PROVIDER SERVICES INC
EIN 83-1369177
Tax Period 202009
Filing Type E
Return Type 990
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
5659377208 2020-04-27 0470 PPP 178 HIGHWAY 24 E, CENTREVILLE, MS, 39631-4171
Loan Status Date 2021-06-16
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 345800
Loan Approval Amount (current) 345800
Undisbursed Amount 0
Franchise Name -
Lender Location ID 39638
Servicing Lender Name United Mississippi Bank
Servicing Lender Address 75 Melrose Montebello Pkwy, NATCHEZ, MS, 39120-4747
Rural or Urban Indicator R
Hubzone Y
LMI N
Business Age Description New Business or 2 years or less
Project Address CENTREVILLE, WILKINSON, MS, 39631-4171
Project Congressional District MS-03
Number of Employees 7
NAICS code 622110
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 39638
Originating Lender Name United Mississippi Bank
Originating Lender Address NATCHEZ, MS
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 117891.7
Forgiveness Paid Date 2021-05-21

Date of last update: 01 Apr 2025

Sources: Mississippi Secretary of State