| Name: | GOOD SAMARITAN PHYSICAL THERAPY, INC. |
| Jurisdiction: | MISSISSIPPI |
| Business Type: | Profit Corporation |
| Status: | Dissolved |
| Effective Date: | 16 Jun 1997 (28 years ago) |
| Business ID: | 643685 |
| ZIP code: | 39180 |
| County: | Warren |
| State of Incorporation: | MISSISSIPPI |
| Principal Office Address: | 1901 A MISSION 66VICKSBURG, MS 39180 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GOOD SAMARITAN PHYSICAL THERAPY, INC. 401(K) PROFIT SHARING PLAN | 2015 | 721380629 | 2016-10-17 | GOOD SAMARITAN PHYSICAL THERAPY, INC. | 33 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 721380629 |
| Plan administrator’s name | GOOD SAMARITAN PHYSICAL THERAPY, INC. |
| Plan administrator’s address | 1901 -A MISSION 66, VICKSBURG, MS, 39180 |
| Administrator’s telephone number | 6016384076 |
Signature of
| Role | Plan administrator |
| Date | 2016-10-17 |
| Name of individual signing | ROD NIXON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2001-01-01 |
| Business code | 621340 |
| Sponsor’s telephone number | 6016384076 |
| Plan sponsor’s address | 1901 -A MISSION 66, VICKSBURG, MS, 39180 |
Plan administrator’s name and address
| Administrator’s EIN | 721380629 |
| Plan administrator’s name | GOOD SAMARITAN PHYSICAL THERAPY, INC. |
| Plan administrator’s address | 1901 -A MISSION 66, VICKSBURG, MS, 39180 |
| Administrator’s telephone number | 6016384076 |
Signature of
| Role | Plan administrator |
| Date | 2015-07-30 |
| Name of individual signing | ROD NIXON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2001-01-01 |
| Business code | 621340 |
| Sponsor’s telephone number | 6016384076 |
| Plan sponsor’s address | 1901 -A MISSION 66, VICKSBURG, MS, 39180 |
Plan administrator’s name and address
| Administrator’s EIN | 721380629 |
| Plan administrator’s name | GOOD SAMARITAN PHYSICAL THERAPY, INC. |
| Plan administrator’s address | 1901 -A MISSION 66, VICKSBURG, MS, 39180 |
| Administrator’s telephone number | 6016384076 |
Signature of
| Role | Plan administrator |
| Date | 2014-07-23 |
| Name of individual signing | ROD NIXON |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| TAMMY DAVENPORT | Agent | 1901 A MISSION 66, P O BOX 822394, VICKSBURG, MS 39182-2394 |
| Name | Role | Address |
|---|---|---|
| Tammy Davenport | Incorporator | 4313 Knights Ln, Vicksburg, MS 39180 |
| Name | Role | Address |
|---|---|---|
| Tammy E Davenport | Director | 1901a Mission 66, Vicksburg, MS 39180 |
| Name | Role | Address |
|---|---|---|
| Tammy E Davenport | President | 1901a Mission 66, Vicksburg, MS 39180 |
| Type | Status | Filed Date | Description |
|---|---|---|---|
| Admin Dissolution | Filed | 2015-12-08 | Admin Dissolution: AR |
| Notice to Dissolve/Revoke | Filed | 2015-09-16 | Notice to Dissolve/Revoke |
| Annual Report | Filed | 2014-02-20 | Annual Report |
| Annual Report | Filed | 2013-07-30 | Annual Report |
| Notice to Dissolve/Revoke | Filed | 2013-07-01 | Notice to Dissolve/Revoke |
| Annual Report | Filed | 2012-11-27 | Annual Report |
| Notice to Dissolve/Revoke | Filed | 2012-09-13 | Notice to Dissolve/Revoke |
| Annual Report | Filed | 2011-04-13 | Annual Report |
| Annual Report | Filed | 2010-03-23 | Annual Report |
| Annual Report | Filed | 2009-04-13 | Annual Report |
Date of last update: 24 Dec 2024
Sources: Mississippi Secretary of State
