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  5. NORTHEAST MISSISSIPPI HEALTH CARE, INC.

NORTHEAST MISSISSIPPI HEALTH CARE, INC.

Company Details

Name: NORTHEAST MISSISSIPPI HEALTH CARE, INC.
Jurisdiction: MISSISSIPPI
Business Type: Non Profit Corporation
Status: Good Standing
Effective Date: 17 Jan 1979 (46 years ago)
Business ID: 201564
ZIP code: 38611
County: Marshall
State of Incorporation: MISSISSIPPI
Principal Office Address: P O BOX 407BYHALIA, MS 38611-407

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NEMHC 401(K) PLAN 2023 640620763 2024-06-12 NORTHEAST MISSISSIPPI HEALTH CARE INC 75
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 6628382098
Plan sponsor’s address 12 EAST BRUNSWICK AVE, PO BOX 698, BYHALIA, MS, 38611

Signature of
Role Plan administrator
Date 2024-06-12
Name of individual signing DEE MILLER
Valid signature Filed with authorized/valid electronic signature
NEMHC 401(K) PLAN 2022 640620763 2023-06-19 NORTHEAST MISSISSIPPI HEALTH CARE INC 74
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 6628382098
Plan sponsor’s address 12 EAST BRUNSWICK AVE, BYHALIA, MS, 38611

Signature of
Role Plan administrator
Date 2023-06-19
Name of individual signing DEMETRIA MILLER
Valid signature Filed with authorized/valid electronic signature
NEMHC 401(K) PLAN 2021 640620763 2022-06-21 NORTHEAST MISSISSIPPI HEALTH CARE INC 78
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 6628382098
Plan sponsor’s address 12 EAST BRUNSWICK AVE, BYHALIA, MS, 38611

Signature of
Role Plan administrator
Date 2022-06-21
Name of individual signing DEMETRIA MILLER
Valid signature Filed with authorized/valid electronic signature
NEMHC 401(K) PLAN 2020 640620763 2021-06-11 NORTHEAST MISSISSIPPI HEALTH CARE INC 73
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 6628382098
Plan sponsor’s address 12 EAST BRUNSWICK AVE, BYHALIA, MS, 38611

Signature of
Role Plan administrator
Date 2021-06-11
Name of individual signing CLIFTON RODGERS MD
Valid signature Filed with authorized/valid electronic signature
NEMHC 401(K) PLAN 2019 640620763 2020-07-09 NORTHEAST MISSISSIPPI HEALTH CARE INC 75
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 6628382098
Plan sponsor’s address 12 EAST BRUNSWICK AVE, BYHALIA, MS, 38611

Signature of
Role Plan administrator
Date 2020-07-09
Name of individual signing CLIFTON RODGERS MD
Valid signature Filed with authorized/valid electronic signature
NEMHC 401(K) PLAN 2018 640620763 2019-09-25 NORTHEAST MISSISSIPPI HEALTH CARE INC 75
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 6628382098
Plan sponsor’s address 12 EAST BRUNSWICK AVE, BYHALIA, MS, 38611

Signature of
Role Plan administrator
Date 2019-09-25
Name of individual signing CLIFTON RODGERS MD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-09-25
Name of individual signing SUZANNE MOULTON
Valid signature Filed with authorized/valid electronic signature
NEMHC 401(K) PLAN 2017 640620763 2018-06-25 NORTHEAST MISSISSIPPI HEALTH CARE INC 74
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 6628382098
Plan sponsor’s address 12 EAST BRUNSWICK AVE, BYHALIA, MS, 38611

Signature of
Role Plan administrator
Date 2018-06-25
Name of individual signing CLIFTON RODGERS MD
Valid signature Filed with authorized/valid electronic signature
NEMHC 401(K) PLAN 2016 640620763 2017-06-13 NORTHEAST MISSISSIPPI HEALTH CARE INC 63
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 6628382098
Plan sponsor’s address 12 EAST BRUNSWICK AVE, BYHALIA, MS, 38611

Signature of
Role Plan administrator
Date 2017-06-13
Name of individual signing CLIFTON RODGERS MD
Valid signature Filed with authorized/valid electronic signature
NEHMC 2015 640620763 2016-07-15 NORTHEAST MISSISSIPPI HEALTH CARE INC 57
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 6628382098
Plan sponsor’s address 12 EAST BRUNSWICK AVE, BYHALIA, MS, 38611

Signature of
Role Plan administrator
Date 2016-07-15
Name of individual signing CLIFTON RODGERS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-07-15
Name of individual signing CLIFTON RODGERS
Valid signature Filed with authorized/valid electronic signature
RETIREMENT PLAN FOR EMPLOYEES OF NEMHC, INC. 2014 640620763 2016-02-29 NORTHEAST MISSISSIPPI HEALTH CARE, INC. 77
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1996-04-01
Business code 621111
Sponsor’s telephone number 6628382098
Plan sponsor’s address PO BOX 698, BYHALIA, MS, 38611

Signature of
Role Plan administrator
Date 2016-02-29
Name of individual signing CLIFTON RODGERS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/09/25/20140925153849P040006660399001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-04-01
Business code 621111
Sponsor’s telephone number 6628382098
Plan sponsor’s address PO BOX 698, BYHALIA, MS, 38611

Signature of
Role Plan administrator
Date 2014-09-25
Name of individual signing CLIFTON RODGERS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/12/26/20131226143004P030142598163001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-04-01
Business code 621111
Sponsor’s telephone number 6628382098
Plan sponsor’s address PO BOX 698, BYHALIA, MS, 386110698

Signature of
Role Plan administrator
Date 2013-12-26
Name of individual signing CLIFTON RODGERS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/12/27/20121227123741P030008109429001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-04-01
Business code 621111
Sponsor’s telephone number 6628382098
Plan sponsor’s address PO BOX 698, BYHALIA, MS, 386110698

Plan administrator’s name and address
Administrator’s EIN 640620763
Plan administrator’s name NORTHEAST MISSISSIPPI HEALTH CARE, INC.
Plan administrator’s address PO BOX 698, BYHALIA, MS, 386110698
Administrator’s telephone number 6628382098

Signature of
Role Plan administrator
Date 2012-12-27
Name of individual signing CLIFTON RODGERS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/09/06/20110906135430P030125424321001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-04-01
Business code 621111
Sponsor’s telephone number 6628382098
Plan sponsor’s address PO BOX 698, 12 EAST BRUNSWICK STREET, BYHALIA, MS, 386110698

Plan administrator’s name and address
Administrator’s EIN 640620763
Plan administrator’s name NORTHEAST MISSISSIPPI HEALTH CARE INC.
Plan administrator’s address PO BOX 698, 12 EAST BRUNSWICK STREET, BYHALIA, MS, 386110698
Administrator’s telephone number 6628382098

Signature of
Role Plan administrator
Date 2011-09-06
Name of individual signing MARJORIE MCKINNEY
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/08/25/20100825173549P030025167014001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1996-04-01
Business code 621111
Sponsor’s telephone number 6628382098
Plan sponsor’s address PO BOX 698, BYHALIA, MS, 386110698

Plan administrator’s name and address
Administrator’s EIN 640620763
Plan administrator’s name NORTHEAST MISSISSIPPI HEALTH CARE INC.
Plan administrator’s address PO BOX 698, BYHALIA, MS, 386110698
Administrator’s telephone number 6628382098

Signature of
Role Plan administrator
Date 2010-08-25
Name of individual signing MARJORIE MCKINNEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-08-25
Name of individual signing MARJORIE MCKINNEY
Valid signature Filed with authorized/valid electronic signature

Incorporator

Name Role Address
GARY E MAHOLM Incorporator B, BYHALIA, MS
SID AYRES Incorporator H, HICKORY FLAT, MS
STAN MOOREHEAD Incorporator H, HICKORY FLAT, MS

Filings

Type Status Filed Date Description
Undetermined Event Filed 1979-01-23 Undetermined Event
Name Reservation Form Filed 1979-01-17 Name Reservation

Awards

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
DO AWARD VA614C00385 2010-09-10 2010-09-30 2014-05-31
Unique Award Key CONT_AWD_VA614C00385_3600_VA249P0486_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title COMMUNITY BASED OUTPATIENT CLINIC BHALYIA, MS
NAICS Code 621498: ALL OTHER OUTPATIENT CARE CENTERS
Product and Service Codes Q999: OTHER MEDICAL SERVICES

Recipient Details
Recipient NORTHEAST MISSISSIPPI HEALTH CARE, INC.
UEI MF17UELZJ753
Legacy DUNS 177103686
Recipient Address 12 E BRUNSWICK, BYHALIA, 386110000, UNITED STATES
DO AWARD V614C90892 2009-09-01 2009-09-30 2014-05-31
Unique Award Key CONT_AWD_V614C90892_3600_VA249P0486_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title PRIMARY HEALTH CARE FOR VETERANS OF MARSHALL COUNTY MISSISSIPPI - LOCATION BYHALIA, MS
NAICS Code 621498: ALL OTHER OUTPATIENT CARE CENTERS
Product and Service Codes Q999: OTHER MEDICAL SERVICES

Recipient Details
Recipient NORTHEAST MISSISSIPPI HEALTH CARE, INC.
UEI MF17UELZJ753
Legacy DUNS 177103686
Recipient Address 12 E BRUNSWICK, BYHALIA, 386110000, UNITED STATES
No data IDV VA249P0486 2008-10-01 No data No data
Unique Award Key CONT_IDV_VA249P0486_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title CBOC - CAPITATED - MARSHALL COUNTY, MS. COMMUNITY BASED OUTPATIENT CLINIC FOR MEMPHIS VAMC PROVIDING PRIMARY HEALTH CARE SERIVCES.
NAICS Code 621498: ALL OTHER OUTPATIENT CARE CENTERS
Product and Service Codes Q201: GENERAL HEALTH CARE SERVICES

Recipient Details
Recipient NORTHEAST MISSISSIPPI HEALTH CARE, INC.
UEI MF17UELZJ753
Legacy DUNS 177103686
Recipient Address 12 E BRUNSWICK, BYHALIA, 386110000, UNITED STATES
DO AWARD V614C90024 2008-10-01 2009-08-31 2014-05-31
Unique Award Key CONT_AWD_V614C90024_3600_VA249P0486_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title PRIMARY HEALTH CARE FOR VETERANS OF MARSHALL COUNTY MISSISSIPPI - LOCATION BYHALIA, MS
NAICS Code 621498: ALL OTHER OUTPATIENT CARE CENTERS
Product and Service Codes Q999: OTHER MEDICAL SERVICES

Recipient Details
Recipient NORTHEAST MISSISSIPPI HEALTH CARE, INC.
UEI MF17UELZJ753
Legacy DUNS 177103686
Recipient Address 12 E BRUNSWICK, BYHALIA, 386110000, UNITED STATES
PURCHASE ORDER AWARD V614C80383 2008-04-01 2008-08-31 2008-08-31
Unique Award Key CONT_AWD_V614C80383_3600_-NONE-_-NONE-
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 41685.00
Current Award Amount 41685.00
Potential Award Amount 41685.00

Description
Title PRIMARY CARE SERVICE FOR VAMC MEMPHIS.
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q509: INTERNAL MEDICINE SERVICES

Recipient Details
Recipient NORTHEAST MISSISSIPPI HEALTH CARE, INC.
UEI MF17UELZJ753
Recipient Address 12 E BRUNSWICK, BYHALIA, MARSHALL, MISSISSIPPI, 386110000, UNITED STATES

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
64-0620763 Corporation Unconditional Exemption PO BOX 698, BYHALIA, MS, 38611-0698 1979-10
In Care of Name -
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 Organization that receives a substantial part of its support from a governmental unit or the general public 170(b)(1)(A)(vi)
Tax Period 2024-03
Asset 5,000,000 to 9,999,999
Income 5,000,000 to 9,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Mar
Asset Amount 5401668
Income Amount 8881058
Form 990 Revenue Amount 8881058
National Taxonomy of Exempt Entities -
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 public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name NORTHEAST MISSISSIPPI HEALTH CARE INC
EIN 64-0620763
Tax Period 202303
Filing Type E
Return Type 990
File View File
Organization Name NORTHEAST MISSISSIPPI HEALTH CARE INC
EIN 64-0620763
Tax Period 202203
Filing Type E
Return Type 990
File View File
Organization Name NORTHEAST MISSISSIPPI HEALTH CARE INC
EIN 64-0620763
Tax Period 202003
Filing Type E
Return Type 990
File View File
Organization Name NORTHEAST MISSISSIPPI HEALTH CARE INC
EIN 64-0620763
Tax Period 201903
Filing Type E
Return Type 990
File View File
Organization Name NORTHEAST MISSISSIPPI HEALTH CARE INC
EIN 64-0620763
Tax Period 201803
Filing Type E
Return Type 990
File View File
Organization Name NORTHEAST MISSISSIPPI HEALTH CARE INC
EIN 64-0620763
Tax Period 201703
Filing Type E
Return Type 990
File View File

Related by officers

SID AYRES

MOFFITT AND WOODS FARMS, LLC

STAN MOOREHEAD

HICKORY FLAT CLINIC ASSOCIATION, INC.

Related by address

No related companies by address

Date of last update: 31 Jan 2025

Sources: Mississippi Secretary of State

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