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NORTH MISSISSIPPI HEALTH SERVICES, INC.

Company Details

Name: NORTH MISSISSIPPI HEALTH SERVICES, INC.
Jurisdiction: MISSISSIPPI
Business Type: Non Profit Corporation
Status: Good Standing
Effective Date: 30 Jul 1981 (44 years ago)
Business ID: 201454
State of Incorporation: DELAWARE
Principal Office Address: 100 W 10TH STWILMINGTON, DE 19801-1645

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NORTH MISSISSIPPI HEALTH SERVICES, INC. LT DISABILITY PLAN 2009 640653269 2011-07-14 NORTH MISSISSIPPI HEALTH SERVICES, INC. 4942
File View Page
Three-digit plan number (PN) 505
Effective date of plan 1994-05-01
Business code 622000
Sponsor’s telephone number 6623773056
Plan sponsor’s mailing address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Plan sponsor’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801

Plan administrator’s name and address
Administrator’s EIN 640653269
Plan administrator’s name NORTH MISSISSIPPI HEALTH SERVICES, INC.
Plan administrator’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Administrator’s telephone number 6623773056

Number of participants as of the end of the plan year
Active participants 4870

Signature of
Role Plan administrator
Date 2011-07-14
Name of individual signing DONNA W. BRUCE
Valid signature Filed with authorized/valid electronic signature
NORTH MISSISSIPPI HEALTH SERVICES, INC. RETIREMENT PLAN & TRUST AGREEMENT 2009 640653269 2011-07-15 NORTH MISSISSIPPI HEALTH SERVICES, INC. 5873
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1977-05-01
Business code 622000
Sponsor’s telephone number 6623773056
Plan sponsor’s mailing address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Plan sponsor’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801

Plan administrator’s name and address
Administrator’s EIN 640653269
Plan administrator’s name NORTH MISSISSIPPI HEALTH SERVICES, INC.
Plan administrator’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Administrator’s telephone number 6623773056

Number of participants as of the end of the plan year
Active participants 3637
Retired or separated participants receiving benefits 515
Other retired or separated participants entitled to future benefits 1810
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 46
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 41

Signature of
Role Plan administrator
Date 2011-07-15
Name of individual signing DONNA W. BRUCE
Valid signature Filed with authorized/valid electronic signature
NORTH MISSISSIPPI HEALTH SERVICES, INC. RETIREMENT PLAN & TRUST AGREEMENT 2009 640653269 2011-07-15 NORTH MISSISSIPPI HEALTH SERVICES, INC. 5873
Three-digit plan number (PN) 001
Effective date of plan 1977-05-01
Business code 622000
Sponsor’s telephone number 6623773056
Plan sponsor’s mailing address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Plan sponsor’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801

Plan administrator’s name and address
Administrator’s EIN 640653269
Plan administrator’s name NORTH MISSISSIPPI HEALTH SERVICES, INC.
Plan administrator’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Administrator’s telephone number 6623773056

Number of participants as of the end of the plan year
Active participants 3637
Retired or separated participants receiving benefits 515
Other retired or separated participants entitled to future benefits 1810
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 46
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 41

Signature of
Role Plan administrator
Date 2011-07-15
Name of individual signing DONNA W. BRUCE
Valid signature Filed with authorized/valid electronic signature
NORTH MISSISSIPPI HEALTH SERVICES, INC. PROFIT SHARING PLAN 2009 640653269 2011-07-15 NORTH MISSISSIPPI HEALTH SERVICES, INC. 6350
File View Page
Three-digit plan number (PN) 003
Effective date of plan 1992-02-01
Business code 622000
Sponsor’s telephone number 6623773056
Plan sponsor’s mailing address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Plan sponsor’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801

Plan administrator’s name and address
Administrator’s EIN 640653269
Plan administrator’s name NORTH MISSISSIPPI HEALTH SERVICES, INC.
Plan administrator’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Administrator’s telephone number 6623773056

Number of participants as of the end of the plan year
Active participants 5510
Retired or separated participants receiving benefits 1
Other retired or separated participants entitled to future benefits 844
Number of participants with account balances as of the end of the plan year 4624
Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested 9

Signature of
Role Plan administrator
Date 2011-07-15
Name of individual signing DONNA W. BRUCE
Valid signature Filed with authorized/valid electronic signature
NORTH MISSISSIPPI HEALTH SERVICES, INC. EMPLOYEE ASSISTANCE PLAN 2009 640653269 2011-07-14 NORTH MISSISSIPPI HEALTH SERVICES, INC. 5278
File View Page
Three-digit plan number (PN) 504
Effective date of plan 1994-02-01
Business code 622000
Sponsor’s telephone number 6623773056
Plan sponsor’s mailing address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Plan sponsor’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801

Plan administrator’s name and address
Administrator’s EIN 640653269
Plan administrator’s name NORTH MISSISSIPPI HEALTH SERVICES, INC.
Plan administrator’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Administrator’s telephone number 6623773056

Number of participants as of the end of the plan year
Active participants 5392

Signature of
Role Plan administrator
Date 2011-07-14
Name of individual signing DONNA W. BRUCE
Valid signature Filed with authorized/valid electronic signature
NORTH MISSISSIPPI HEALTH SERVICES, INC. EMPLOYEE ASSISTANCE PLAN 2009 640653269 2011-07-13 NORTH MISSISSIPPI HEALTH SERVICES, INC. 5278
Three-digit plan number (PN) 504
Effective date of plan 1994-02-01
Business code 622000
Sponsor’s telephone number 6623773056
Plan sponsor’s mailing address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Plan sponsor’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801

Plan administrator’s name and address
Plan administrator’s name SAME

Number of participants as of the end of the plan year
Active participants 5392

Signature of
Role Plan administrator
Date 2011-07-13
Name of individual signing DONNA W. BRUCE
Valid signature Filed with authorized/valid electronic signature
NORTH MISSISSIPPI HEALTH SERVICES, INC. LT DISABILITY PLAN 2009 640653269 2011-07-13 NORTH MISSISSIPPI HEALTH SERVICES, INC. 4942
Three-digit plan number (PN) 505
Effective date of plan 1994-05-01
Business code 622000
Sponsor’s telephone number 6623773056
Plan sponsor’s mailing address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Plan sponsor’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801

Plan administrator’s name and address
Plan administrator’s name SAME

Number of participants as of the end of the plan year
Active participants 4870

Signature of
Role Plan administrator
Date 2011-07-13
Name of individual signing DONNA W. BRUCE
Valid signature Filed with authorized/valid electronic signature
NORTH MISSISSIPPI HEALTH SERVICES, INC. GROUP LIFE PLAN 2009 640653269 2011-07-13 NORTH MISSISSIPPI HEALTH SERVICES, INC. 5339
Three-digit plan number (PN) 509
Effective date of plan 1977-01-01
Business code 622000
Sponsor’s telephone number 6623773056
Plan sponsor’s mailing address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Plan sponsor’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801

Plan administrator’s name and address
Plan administrator’s name SAME

Number of participants as of the end of the plan year
Active participants 5389

Signature of
Role Plan administrator
Date 2011-07-13
Name of individual signing DONNA W. BRUCE
Valid signature Filed with authorized/valid electronic signature
NORTH MISSISSIPPI HEALTH SERVICES, INC. GROUP LIFE PLAN 2009 640653269 2011-07-14 NORTH MISSISSIPPI HEALTH SERVICES, INC. 5339
File View Page
Three-digit plan number (PN) 509
Effective date of plan 1977-01-01
Business code 622000
Sponsor’s telephone number 6623773056
Plan sponsor’s mailing address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Plan sponsor’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801

Plan administrator’s name and address
Administrator’s EIN 640653269
Plan administrator’s name NORTH MISSISSIPPI HEALTH SERVICES, INC.
Plan administrator’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Administrator’s telephone number 6623773056

Number of participants as of the end of the plan year
Active participants 5389

Signature of
Role Plan administrator
Date 2011-07-14
Name of individual signing DONNA W. BRUCE
Valid signature Filed with authorized/valid electronic signature
NORTH MISSISSIPPI HEALTH SERVICES, INC. TAX SHELTERED ANNUITY PLAN 2009 640653269 2010-10-18 NORTH MISSISSIPPI HEALTH SERVICES, INC. 6284
Three-digit plan number (PN) 002
Effective date of plan 1991-11-01
Business code 622000
Sponsor’s telephone number 6628413000
Plan sponsor’s mailing address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Plan sponsor’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801

Plan administrator’s name and address
Administrator’s EIN 640653269
Plan administrator’s name NORTH MISSISSIPPI HEALTH SERVICES, INC.
Plan administrator’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Administrator’s telephone number 6628413000

Number of participants as of the end of the plan year
Active participants 5907
Other retired or separated participants entitled to future benefits 791
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1
Number of participants with account balances as of the end of the plan year 4768

Signature of
Role Plan administrator
Date 2010-10-18
Name of individual signing DONNA W. BRUCE
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/18/20101018115823P070034338401001.pdf
Three-digit plan number (PN) 506
Effective date of plan 1997-01-01
Business code 621112
Sponsor’s telephone number 6628413000
Plan sponsor’s mailing address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Plan sponsor’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801

Plan administrator’s name and address
Administrator’s EIN 640653269
Plan administrator’s name NORTH MISSISSIPPI HEALTH SERVICES, INC.
Plan administrator’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Administrator’s telephone number 6628413000

Number of participants as of the end of the plan year
Active participants 5294
Retired or separated participants receiving benefits 57

Signature of
Role Plan administrator
Date 2010-10-18
Name of individual signing PENNY R. WOOD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/18/20101018142505P030013150642001.pdf
Three-digit plan number (PN) 510
Effective date of plan 1997-01-01
Business code 621112
Sponsor’s telephone number 6628413000
Plan sponsor’s mailing address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Plan sponsor’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801

Plan administrator’s name and address
Administrator’s EIN 640653269
Plan administrator’s name NORTH MISSISSIPPI HEALTH SERVICES, INC.
Plan administrator’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Administrator’s telephone number 6628413000

Number of participants as of the end of the plan year
Active participants 5278
Retired or separated participants receiving benefits 46

Signature of
Role Plan administrator
Date 2010-10-18
Name of individual signing PENNY R. WOOD
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 510
Effective date of plan 1997-01-01
Business code 621112
Sponsor’s telephone number 6628413000
Plan sponsor’s mailing address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Plan sponsor’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801

Plan administrator’s name and address
Administrator’s EIN 640653269
Plan administrator’s name NORTH MISSISSIPPI HEALTH SERVICES, INC.
Plan administrator’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Administrator’s telephone number 6628413000

Number of participants as of the end of the plan year
Active participants 5278
Retired or separated participants receiving benefits 46

Signature of
Role Plan administrator
Date 2010-10-18
Name of individual signing PENNY R. WOOD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/21/20101021105506P070017870866001.pdf
Three-digit plan number (PN) 002
Effective date of plan 1991-11-01
Business code 622000
Sponsor’s telephone number 6628413000
Plan sponsor’s mailing address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Plan sponsor’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801

Plan administrator’s name and address
Administrator’s EIN 640653269
Plan administrator’s name NORTH MISSISSIPPI HEALTH SERVICES, INC.
Plan administrator’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Administrator’s telephone number 6628413000

Number of participants as of the end of the plan year
Active participants 5907
Other retired or separated participants entitled to future benefits 791
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1
Number of participants with account balances as of the end of the plan year 4768

Signature of
Role Plan administrator
Date 2010-10-21
Name of individual signing DONNA W. BRUCE
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 002
Effective date of plan 1991-11-01
Business code 622000
Sponsor’s telephone number 6628413000
Plan sponsor’s mailing address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Plan sponsor’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801

Plan administrator’s name and address
Administrator’s EIN 640653269
Plan administrator’s name NORTH MISSISSIPPI HEALTH SERVICES, INC.
Plan administrator’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Administrator’s telephone number 6628413000

Number of participants as of the end of the plan year
Active participants 5907
Other retired or separated participants entitled to future benefits 791
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 1
Number of participants with account balances as of the end of the plan year 4768
Three-digit plan number (PN) 510
Effective date of plan 1997-01-01
Business code 621112
Sponsor’s telephone number 6628413000
Plan sponsor’s mailing address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Plan sponsor’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801

Plan administrator’s name and address
Administrator’s EIN 640653269
Plan administrator’s name NORTH MISSISSIPPI HEALTH SERVICES, INC.
Plan administrator’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Administrator’s telephone number 6628413000

Number of participants as of the end of the plan year
Active participants 5278
Retired or separated participants receiving benefits 46

Signature of
Role Plan administrator
Date 2010-10-14
Name of individual signing PENNY R. WOOD
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 506
Effective date of plan 1997-01-01
Business code 621112
Sponsor’s telephone number 6628413000
Plan sponsor’s mailing address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Plan sponsor’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801

Plan administrator’s name and address
Administrator’s EIN 640653269
Plan administrator’s name NORTH MISSISSIPPI HEALTH SERVICES, INC.
Plan administrator’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Administrator’s telephone number 6628413000

Number of participants as of the end of the plan year
Active participants 5294
Retired or separated participants receiving benefits 57

Signature of
Role Plan administrator
Date 2010-10-14
Name of individual signing PENNY R. WOOD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/26/20100726145223P030017286341001.pdf
Three-digit plan number (PN) 509
Plan sponsor’s mailing address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Plan sponsor’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801

Plan administrator’s name and address
Administrator’s EIN 640653269
Plan administrator’s name NORTH MISSISSIPPI HEALTH SERVICES, INC.
Plan administrator’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/26/20100726145212P030017286325001.pdf
Three-digit plan number (PN) 504
Plan sponsor’s mailing address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Plan sponsor’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801

Plan administrator’s name and address
Administrator’s EIN 640653269
Plan administrator’s name NORTH MISSISSIPPI HEALTH SERVICES, INC.
Plan administrator’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/26/20100726145200P040097704184001.pdf
Three-digit plan number (PN) 505
Plan sponsor’s mailing address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801
Plan sponsor’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801

Plan administrator’s name and address
Administrator’s EIN 640653269
Plan administrator’s name NORTH MISSISSIPPI HEALTH SERVICES, INC.
Plan administrator’s address 830 SOUTH GLOSTER STREET, TUPELO, MS, 38801

Agent

Name Role Address
BRUCE J. TOPPIN Agent 830 S GLOSTER, TUPELO, MS 38801

Incorporator

Name Role Address
F M BUSH III Incorporator 316 COURT ST, P O BOX 648, TUPELO, MS 10000

Filings

Type Status Filed Date Description
Amendment Form Filed 1996-07-16 Amendment
Amendment Form Filed 1984-07-24 Amendment
See File Filed 1982-08-12 See File
Name Reservation Form Filed 1981-07-30 Name Reservation

USAspending Awards. Financial Assistance

FAIN Awarding Agency Assistance Listings Start Date End Date Description
P06HA03441 Department of Health and Human Services 93.918 - GRANTS TO PROVIDE OUTPATIENT EARLY INTERVENTION SERVICES WITH RESPECT TO HIV DISEASE 2004-08-01 2005-07-31 RYAN WHITE TITLE III HIV CAPACITY DEVELOPMENT AND PLANNING GRANTS
Recipient NORTH MISSISSIPPI HEALTH SERVICES INC
Recipient Name Raw NORTH MISSISSIPPI HEALTH SERVICES
Recipient UEI TGPAPG89LW44
Recipient DUNS 115269813
Recipient Address 830 SOUTH GLOSTER STREET, TUPELO, LEE, MISSISSIPPI, 38801
Obligated Amount -51061.00
Non-Federal Funding 0.00
Original Subsidy Cost 0.00
Face Value of Direct Loan 0.00
Link View Page

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
64-0653269 Corporation Unconditional Exemption 830 S GLOSTER ST, TUPELO, MS, 38801-4934 1982-05
In Care of Name % KRISTY DUKE
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 Organizations operated solely for the benefit of and in conjunction with organizations described in 10 through 16 above 509(a)(3)
Tax Period 2023-09
Asset 50,000,000 to greater
Income 50,000,000 to greater
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Sep
Asset Amount 112056771
Income Amount 54101904
Form 990 Revenue Amount 53359371
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 supporting organization, unspecified type. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name NORTH MISSISSIPPI HEALTH SERVICES INC
EIN 64-0653269
Tax Period 202109
Filing Type E
Return Type 990
File View File
Organization Name NORTH MISSISSIPPI HEALTH SERVICES INC
EIN 64-0653269
Tax Period 202009
Filing Type E
Return Type 990
File View File
Organization Name NORTH MISSISSIPPI HEALTH SERVICES INC
EIN 64-0653269
Tax Period 201909
Filing Type E
Return Type 990
File View File
Organization Name NORTH MISSISSIPPI HEALTH SERVICES INC
EIN 64-0653269
Tax Period 201809
Filing Type E
Return Type 990
File View File
Organization Name NORTH MISSISSIPPI HEALTH SERVICES INC
EIN 64-0653269
Tax Period 201709
Filing Type E
Return Type 990
File View File
Organization Name NORTH MISSISSIPPI HEALTH SERVICES INC
EIN 64-0653269
Tax Period 201609
Filing Type E
Return Type 990
File View File

Motor Carrier Census

USDOT Number Carrier Operation MCS-150 Form Date MCS-150 Mileage MCS-150 Year Power Units Drivers Operation Classification
428896 Intrastate Non-Hazmat 2023-06-23 310000 2022 16 16 Private(Property), MEDICAL SUPPLIES
Legal Name NORTH MISSISSIPPI HEALTH SERVICES
DBA Name -
Physical Address 830 S GLOSTER ST, TUPELO, MS, 38801-4934, US
Mailing Address 830 S GLOSTER ST, TUPELO, MS, 38801-4934, US
Phone (662) 377-3000
Fax (662) 377-2739
E-mail KPOTTS@NMHS.NET

Safety Measurement System - All Transportation
Total Number of Inspections for the measurement period (24 months) 12
Driver Fitness BASIC Serious Violation Indicator No
Vehicle Maintenance BASIC Acute/Critical Indicator No
Unsafe Driving BASIC Acute/Critical Indicator No
Driver Fitness BASIC Roadside Performance measure value 0
Hours-of-Service (HOS) Compliance BASIC Roadside Performance measure value 0
Total Number of Driver Inspections for the measurment period 12
Vehicle Maintenance BASIC Roadside Performance measure value 1.68
Total Number of Vehicle Inspections for the measurement period 10
Controlled Substances and Alcohol BASIC Roadside Performance measure value 0
Unsafe Driving BASIC Roadside Performance Measure Value 0
Number of inspections with at least one Driver Fitness BASIC violation 0
Number of inspections with at least one Hours-of-Service BASIC violation 0
Total Number of Driver Inspections containing at least one Driver Out-of-Service Violation 0
Number of inspections with at least one Vehicle Maintenance BASIC violation 3
Total Number of Vehicle Inspections containing at least one Vehicle Out-of-Service violation 2
Number of inspections with at least one Controlled Substances and Alcohol BASIC violation 0
Number of inspections with at least one Unsafe Driving BASIC violation 0

Inspections
Unique report number of the inspection 2004000046
State abbreviation that indicates the state the inspector is from MS
The date of the inspection 2024-06-26
ID that indicates the level of inspection Full
State abbreviation that indicates where the inspection occurred MS
Time weight of the inspection 2
Number of Out-Of-Service violations related to Driver 0
Number of Out-Of-Service violations related to vehicle 0
Number of violations related to Hazardous Materials 0
Total number of Out-Of-Service violations 0
Total number of Out-Of-Service violations related to Hazardous Materials 0
Description of the type of the main unit STRAIGHT TRUCK
Description of the make of the main unit FRHT
License plate of the main unit B2621272
License state of the main unit MS
Vehicle Identification Number of the main unit 1FVACWDT88BDAY532
Unsafe Driving BASIC inspection Y
Hours-of-Service Compliance BASIC inspection Y
Driver Fitness BASIC inspection Y
Controlled Substances/Alcohol BASIC inspection Y
Vehicle Maintenance BASIC inspection Y
Total number of BASIC violations 0
Number of Unsafe Driving BASIC violations 0
Number of Hours-of-Service Compliance BASIC violations 0
Number of Driver Fitness BASIC violations 0
Number of Controlled Substances/Alcohol BASIC violations 0
Number of Vehicle Maintenance BASIC violations 0
Number of Hazardous Materials Compliance BASIC violations 0
Unique report number of the inspection 0U34002008
State abbreviation that indicates the state the inspector is from MS
The date of the inspection 2024-04-29
ID that indicates the level of inspection Walk-around
State abbreviation that indicates where the inspection occurred MS
Time weight of the inspection 2
Number of Out-Of-Service violations related to Driver 0
Number of Out-Of-Service violations related to vehicle 1
Number of violations related to Hazardous Materials 0
Total number of Out-Of-Service violations 1
Total number of Out-Of-Service violations related to Hazardous Materials 0
Description of the type of the main unit STRAIGHT TRUCK
Description of the make of the main unit FRHT
License plate of the main unit B2621076
License state of the main unit MS
Vehicle Identification Number of the main unit 1FVACWDT58DAB0520
Unsafe Driving BASIC inspection Y
Hours-of-Service Compliance BASIC inspection Y
Driver Fitness BASIC inspection Y
Controlled Substances/Alcohol BASIC inspection Y
Vehicle Maintenance BASIC inspection Y
Total number of BASIC violations 1
Number of Unsafe Driving BASIC violations 0
Number of Hours-of-Service Compliance BASIC violations 0
Number of Driver Fitness BASIC violations 0
Number of Controlled Substances/Alcohol BASIC violations 0
Number of Vehicle Maintenance BASIC violations 1
Number of Hazardous Materials Compliance BASIC violations 0
Unique report number of the inspection U033008121
State abbreviation that indicates the state the inspector is from MS
The date of the inspection 2024-01-22
ID that indicates the level of inspection Driver-Only
State abbreviation that indicates where the inspection occurred MS
Time weight of the inspection 2
Number of Out-Of-Service violations related to Driver 0
Number of Out-Of-Service violations related to vehicle 0
Number of violations related to Hazardous Materials 0
Total number of Out-Of-Service violations 0
Total number of Out-Of-Service violations related to Hazardous Materials 0
Description of the type of the main unit STRAIGHT TRUCK
Description of the make of the main unit FRHT
License plate of the main unit B265415
License state of the main unit MS
Vehicle Identification Number of the main unit 1FVACWDT0CHBN9598
Unsafe Driving BASIC inspection Y
Hours-of-Service Compliance BASIC inspection Y
Driver Fitness BASIC inspection Y
Controlled Substances/Alcohol BASIC inspection Y
Total number of BASIC violations 0
Number of Unsafe Driving BASIC violations 0
Number of Hours-of-Service Compliance BASIC violations 0
Number of Driver Fitness BASIC violations 0
Number of Controlled Substances/Alcohol BASIC violations 0
Number of Vehicle Maintenance BASIC violations 0
Number of Hazardous Materials Compliance BASIC violations 0
Unique report number of the inspection 0U34001750
State abbreviation that indicates the state the inspector is from MS
The date of the inspection 2023-09-29
ID that indicates the level of inspection Walk-around
State abbreviation that indicates where the inspection occurred MS
Time weight of the inspection 1
Number of Out-Of-Service violations related to Driver 0
Number of Out-Of-Service violations related to vehicle 0
Number of violations related to Hazardous Materials 0
Total number of Out-Of-Service violations 0
Total number of Out-Of-Service violations related to Hazardous Materials 0
Description of the type of the main unit STRAIGHT TRUCK
Description of the make of the main unit STRG
License plate of the main unit B265414
License state of the main unit MS
Vehicle Identification Number of the main unit 2FZACFCS07AY5316
Unsafe Driving BASIC inspection Y
Hours-of-Service Compliance BASIC inspection Y
Driver Fitness BASIC inspection Y
Controlled Substances/Alcohol BASIC inspection Y
Vehicle Maintenance BASIC inspection Y
Total number of BASIC violations 2
Number of Unsafe Driving BASIC violations 0
Number of Hours-of-Service Compliance BASIC violations 0
Number of Driver Fitness BASIC violations 0
Number of Controlled Substances/Alcohol BASIC violations 0
Number of Vehicle Maintenance BASIC violations 2
Number of Hazardous Materials Compliance BASIC violations 0
Unique report number of the inspection 1021011666
State abbreviation that indicates the state the inspector is from MS
The date of the inspection 2023-09-05
ID that indicates the level of inspection Walk-around
State abbreviation that indicates where the inspection occurred MS
Time weight of the inspection 1
Number of Out-Of-Service violations related to Driver 0
Number of Out-Of-Service violations related to vehicle 0
Number of violations related to Hazardous Materials 0
Total number of Out-Of-Service violations 0
Total number of Out-Of-Service violations related to Hazardous Materials 0
Description of the type of the main unit STRAIGHT TRUCK
Description of the make of the main unit FRHT
License plate of the main unit B261500
License state of the main unit MS
Vehicle Identification Number of the main unit 1FVACWDTXBDAY5323
Unsafe Driving BASIC inspection Y
Hours-of-Service Compliance BASIC inspection Y
Driver Fitness BASIC inspection Y
Controlled Substances/Alcohol BASIC inspection Y
Vehicle Maintenance BASIC inspection Y
Total number of BASIC violations 0
Number of Unsafe Driving BASIC violations 0
Number of Hours-of-Service Compliance BASIC violations 0
Number of Driver Fitness BASIC violations 0
Number of Controlled Substances/Alcohol BASIC violations 0
Number of Vehicle Maintenance BASIC violations 0
Number of Hazardous Materials Compliance BASIC violations 0
Unique report number of the inspection 1027011965
State abbreviation that indicates the state the inspector is from MS
The date of the inspection 2023-08-17
ID that indicates the level of inspection Walk-around
State abbreviation that indicates where the inspection occurred MS
Time weight of the inspection 1
Number of Out-Of-Service violations related to Driver 0
Number of Out-Of-Service violations related to vehicle 0
Number of violations related to Hazardous Materials 0
Total number of Out-Of-Service violations 0
Total number of Out-Of-Service violations related to Hazardous Materials 0
Description of the type of the main unit STRAIGHT TRUCK
Description of the make of the main unit INTL
License plate of the main unit B265794
License state of the main unit MS
Vehicle Identification Number of the main unit 1HTMMMML0FH711406
Unsafe Driving BASIC inspection Y
Hours-of-Service Compliance BASIC inspection Y
Driver Fitness BASIC inspection Y
Controlled Substances/Alcohol BASIC inspection Y
Vehicle Maintenance BASIC inspection Y
Total number of BASIC violations 0
Number of Unsafe Driving BASIC violations 0
Number of Hours-of-Service Compliance BASIC violations 0
Number of Driver Fitness BASIC violations 0
Number of Controlled Substances/Alcohol BASIC violations 0
Number of Vehicle Maintenance BASIC violations 0
Number of Hazardous Materials Compliance BASIC violations 0
Unique report number of the inspection 1017011238
State abbreviation that indicates the state the inspector is from MS
The date of the inspection 2023-08-09
ID that indicates the level of inspection Driver-Only
State abbreviation that indicates where the inspection occurred MS
Time weight of the inspection 1
Number of Out-Of-Service violations related to Driver 0
Number of Out-Of-Service violations related to vehicle 0
Number of violations related to Hazardous Materials 0
Total number of Out-Of-Service violations 0
Total number of Out-Of-Service violations related to Hazardous Materials 0
Description of the type of the main unit STRAIGHT TRUCK
Description of the make of the main unit INTL
License plate of the main unit B265794
License state of the main unit MS
Vehicle Identification Number of the main unit 1HTMMMML0FH711406
Unsafe Driving BASIC inspection Y
Hours-of-Service Compliance BASIC inspection Y
Driver Fitness BASIC inspection Y
Controlled Substances/Alcohol BASIC inspection Y
Total number of BASIC violations 0
Number of Unsafe Driving BASIC violations 0
Number of Hours-of-Service Compliance BASIC violations 0
Number of Driver Fitness BASIC violations 0
Number of Controlled Substances/Alcohol BASIC violations 0
Number of Vehicle Maintenance BASIC violations 0
Number of Hazardous Materials Compliance BASIC violations 0
Unique report number of the inspection 2005011476
State abbreviation that indicates the state the inspector is from MS
The date of the inspection 2023-07-10
ID that indicates the level of inspection Walk-around
State abbreviation that indicates where the inspection occurred MS
Time weight of the inspection 1
Number of Out-Of-Service violations related to Driver 0
Number of Out-Of-Service violations related to vehicle 0
Number of violations related to Hazardous Materials 0
Total number of Out-Of-Service violations 0
Total number of Out-Of-Service violations related to Hazardous Materials 0
Description of the type of the main unit TRUCK TRACTOR
Description of the make of the main unit INTL
License plate of the main unit B2665413
License state of the main unit MS
Vehicle Identification Number of the main unit 1HTMMMML7HH503428
Unsafe Driving BASIC inspection Y
Hours-of-Service Compliance BASIC inspection Y
Driver Fitness BASIC inspection Y
Controlled Substances/Alcohol BASIC inspection Y
Vehicle Maintenance BASIC inspection Y
Total number of BASIC violations 0
Number of Unsafe Driving BASIC violations 0
Number of Hours-of-Service Compliance BASIC violations 0
Number of Driver Fitness BASIC violations 0
Number of Controlled Substances/Alcohol BASIC violations 0
Number of Vehicle Maintenance BASIC violations 0
Number of Hazardous Materials Compliance BASIC violations 0
Unique report number of the inspection 1013011617
State abbreviation that indicates the state the inspector is from MS
The date of the inspection 2023-06-23
ID that indicates the level of inspection Full
State abbreviation that indicates where the inspection occurred MS
Time weight of the inspection 1
Number of Out-Of-Service violations related to Driver 0
Number of Out-Of-Service violations related to vehicle 1
Number of violations related to Hazardous Materials 0
Total number of Out-Of-Service violations 1
Total number of Out-Of-Service violations related to Hazardous Materials 0
Description of the type of the main unit STRAIGHT TRUCK
Description of the make of the main unit INTL
License plate of the main unit B265794
License state of the main unit MS
Vehicle Identification Number of the main unit 1HTMMMML0FH711406
Unsafe Driving BASIC inspection Y
Hours-of-Service Compliance BASIC inspection Y
Driver Fitness BASIC inspection Y
Controlled Substances/Alcohol BASIC inspection Y
Vehicle Maintenance BASIC inspection Y
Total number of BASIC violations 1
Number of Unsafe Driving BASIC violations 0
Number of Hours-of-Service Compliance BASIC violations 0
Number of Driver Fitness BASIC violations 0
Number of Controlled Substances/Alcohol BASIC violations 0
Number of Vehicle Maintenance BASIC violations 1
Number of Hazardous Materials Compliance BASIC violations 0
Unique report number of the inspection 2003011387
State abbreviation that indicates the state the inspector is from MS
The date of the inspection 2023-05-04
ID that indicates the level of inspection Walk-around
State abbreviation that indicates where the inspection occurred MS
Time weight of the inspection 1
Number of Out-Of-Service violations related to Driver 0
Number of Out-Of-Service violations related to vehicle 0
Number of violations related to Hazardous Materials 0
Total number of Out-Of-Service violations 0
Total number of Out-Of-Service violations related to Hazardous Materials 0
Description of the type of the main unit TRUCK TRACTOR
Description of the make of the main unit INTL
License plate of the main unit B265794
License state of the main unit MS
Vehicle Identification Number of the main unit 1HTMMMML0FH711406
Unsafe Driving BASIC inspection Y
Hours-of-Service Compliance BASIC inspection Y
Driver Fitness BASIC inspection Y
Controlled Substances/Alcohol BASIC inspection Y
Vehicle Maintenance BASIC inspection Y
Total number of BASIC violations 0
Number of Unsafe Driving BASIC violations 0
Number of Hours-of-Service Compliance BASIC violations 0
Number of Driver Fitness BASIC violations 0
Number of Controlled Substances/Alcohol BASIC violations 0
Number of Vehicle Maintenance BASIC violations 0
Number of Hazardous Materials Compliance BASIC violations 0
Unique report number of the inspection 2007011889
State abbreviation that indicates the state the inspector is from MS
The date of the inspection 2023-03-22
ID that indicates the level of inspection Walk-around
State abbreviation that indicates where the inspection occurred MS
Time weight of the inspection 1
Number of Out-Of-Service violations related to Driver 0
Number of Out-Of-Service violations related to vehicle 0
Number of violations related to Hazardous Materials 0
Total number of Out-Of-Service violations 0
Total number of Out-Of-Service violations related to Hazardous Materials 0
Description of the type of the main unit STRAIGHT TRUCK
Description of the make of the main unit INTL
License plate of the main unit B265413
License state of the main unit MS
Vehicle Identification Number of the main unit 1HTMMMML7HH503428
Unsafe Driving BASIC inspection Y
Hours-of-Service Compliance BASIC inspection Y
Driver Fitness BASIC inspection Y
Controlled Substances/Alcohol BASIC inspection Y
Vehicle Maintenance BASIC inspection Y
Total number of BASIC violations 0
Number of Unsafe Driving BASIC violations 0
Number of Hours-of-Service Compliance BASIC violations 0
Number of Driver Fitness BASIC violations 0
Number of Controlled Substances/Alcohol BASIC violations 0
Number of Vehicle Maintenance BASIC violations 0
Number of Hazardous Materials Compliance BASIC violations 0
Unique report number of the inspection 1019010799
State abbreviation that indicates the state the inspector is from MS
The date of the inspection 2023-02-22
ID that indicates the level of inspection Walk-around
State abbreviation that indicates where the inspection occurred MS
Time weight of the inspection 1
Number of Out-Of-Service violations related to Driver 0
Number of Out-Of-Service violations related to vehicle 0
Number of violations related to Hazardous Materials 0
Total number of Out-Of-Service violations 0
Total number of Out-Of-Service violations related to Hazardous Materials 0
Description of the type of the main unit STRAIGHT TRUCK
Description of the make of the main unit INTL
License plate of the main unit B265794
License state of the main unit MS
Vehicle Identification Number of the main unit 1HTMMMML0FH711406
Unsafe Driving BASIC inspection Y
Hours-of-Service Compliance BASIC inspection Y
Driver Fitness BASIC inspection Y
Controlled Substances/Alcohol BASIC inspection Y
Vehicle Maintenance BASIC inspection Y
Total number of BASIC violations 0
Number of Unsafe Driving BASIC violations 0
Number of Hours-of-Service Compliance BASIC violations 0
Number of Driver Fitness BASIC violations 0
Number of Controlled Substances/Alcohol BASIC violations 0
Number of Vehicle Maintenance BASIC violations 0
Number of Hazardous Materials Compliance BASIC violations 0

Violations
The date of the inspection 2024-04-29
Code of the violation 393209D
Name of the BASIC Vehicle Maintenance
The violation is identified as Out-Of-Service violation Y
The weight that is assigned to a violation if it's identified as an Out-Of-Service violation 2
The severity weight that is assigned to a violation 6
The time weight that is assigned to a violation 2
The description of a violation Steering system components worn welded or missing
The description of the violation group Steering Mechanism
The unit a violation is cited against Vehicle main unit
The date of the inspection 2023-09-29
Code of the violation 39330
Name of the BASIC Vehicle Maintenance
The violation is identified as Out-Of-Service violation N
The weight that is assigned to a violation if it's identified as an Out-Of-Service violation 0
The severity weight that is assigned to a violation 3
The time weight that is assigned to a violation 1
The description of a violation Improper battery installation
The description of the violation group Other Vehicle Defect
The unit a violation is cited against Vehicle main unit
The date of the inspection 2023-09-29
Code of the violation 393203
Name of the BASIC Vehicle Maintenance
The violation is identified as Out-Of-Service violation N
The weight that is assigned to a violation if it's identified as an Out-Of-Service violation 0
The severity weight that is assigned to a violation 2
The time weight that is assigned to a violation 1
The description of a violation Cab/body parts requirements violations
The description of the violation group Cab Body Frame
The unit a violation is cited against Vehicle main unit
The date of the inspection 2023-06-23
Code of the violation 39345
Name of the BASIC Vehicle Maintenance
The violation is identified as Out-Of-Service violation Y
The weight that is assigned to a violation if it's identified as an Out-Of-Service violation 2
The severity weight that is assigned to a violation 4
The time weight that is assigned to a violation 1
The description of a violation Brake tubing and hose adequacy
The description of the violation group Brakes All Others
The unit a violation is cited against Vehicle main unit

Related by officers

BRUCE J. TOPPIN

NORTH MISSISSIPPI DIALYSIS SERVICES, INC. TUPELO SERVICE FINANCE, INC. CLAY COUNTY MEDICAL CORPORATION NORTH MISSISSIPPI MEDICAL CENTER, INC. NORTH MISSISSIPPI SURGERY CENTER, INC. TISHOMINGO HEALTH SERVICES, INC. NORTH MISSISSIPPI MANAGEMENT SERVICES, INC. ITAWAMBA HEALTH SERVICES, INC. NORTH MISSISSIPPI EMERGENCY SERVICES, INC. NORTH MISSISSIPPI FAMILY MEDICAL CLINICS, INC.

F M BUSH III

SHARED HOSPITAL SERVICES OF MISSISSIPPI, INC. SCHUBERT INDUSTRIES OF MISSISSIPPI, INC. A. J. STAUB III AND ASSOCIATES, P. A. JOHNSON & MCCARTY, P. A. PEOPLOUNGERS, INC. PERFORMANCE IMPROVEMENT AFFILIATES, INC. BROWN ROBERTSON, M.D., P.A. JOHNSON & MCCARTY, P.A. JOHNSON, MCCARTY & HANSEN, P. A. JONES, COOPER & HORTON, ANESTHESIOLOGISTS, P. A.

Related by address

100 W 10TH STWILMINGTON, DE 19801-1645

SECURITY PACIFIC MORTGAGE CORPORATION SERACO ENTERPRISES, INC. SERVITRON, INC. SEWARD EXPLORATION LTD. LIFEMARK DENTAL SERVICES, INC. LIFEMARK PHARMACY MANAGEMENT, INC. LIFETIME COMMUNITIES, INC. THE LIMITED STORES, INC. THE LINDSAY WIRE WEAVING COMPANY LONGHORN PETROLEUM COMPANY

Date of last update: 16 Apr 2025

Sources: Mississippi Secretary of State

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