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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 (43 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

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: 11 Dec 2024

Sources: Mississippi Secretary of State

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