| Name: | CEDAR LAKE MEDICAL CENTER, P.A. |
| Jurisdiction: | MISSISSIPPI |
| Business Type: | Profit Corporation |
| Status: | Dissolved |
| Effective Date: | 29 Sep 1997 (27 years ago) |
| Business ID: | 647435 |
| ZIP code: | 39532 |
| County: | Harrison |
| State of Incorporation: | MISSISSIPPI |
| Principal Office Address: | 1759 MEDICAL PARK DRBILOXI, MS 39532 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CEDAR LAKE MEDICAL CENTER, P.A./COASTAL MEDS, LLC 401(K) PLAN | 2016 | 721397004 | 2017-07-24 | CEDAR LAKE MEDICAL CENTER, P.A. | 12 | |||||||||||||||||||||||||||||||||
|
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| Role | Plan administrator |
| Date | 2017-07-24 |
| Name of individual signing | RICKEY CHANCE |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2017-07-24 |
| Name of individual signing | RICKEY CHANCE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1997-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2283850075 |
| Plan sponsor’s address | 1759 MEDICAL PARK DRIVE, BILOXI, MS, 39532 |
Signature of
| Role | Plan administrator |
| Date | 2016-06-26 |
| Name of individual signing | RICKEY CHANCE |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2016-06-26 |
| Name of individual signing | RICKEY CHANCE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1997-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2283850075 |
| Plan sponsor’s address | 1759 MEDICAL PARK DRIVE, BILOXI, MS, 39532 |
Signature of
| Role | Plan administrator |
| Date | 2015-08-10 |
| Name of individual signing | RICKEY CHANCE |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2015-08-10 |
| Name of individual signing | RICKEY CHANCE |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1997-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 2283850075 |
| Plan sponsor’s address | 1759 MEDICAL PARK DRIVE, BILOXI, MS, 39532 |
Signature of
| Role | Plan administrator |
| Date | 2014-09-08 |
| Name of individual signing | RICKEY CHANCE |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2014-09-08 |
| Name of individual signing | RICKEY CHANCE |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| RICKEY L CHANCE | Agent | 1759 MEDICAL PARK DR, BILOXI, MS 39532 |
| Name | Role | Address |
|---|---|---|
| Rickey L Chance | Incorporator | 4 Schooner Ln, Ocean Springs, MS 39564 |
| Name | Role | Address |
|---|---|---|
| Rickey L Chance | Director | 1610 Girvan Court, Ocean Springs, MS 39564 |
| Name | Role | Address |
|---|---|---|
| Rickey L Chance | President | 1610 Girvan Court, Ocean Springs, MS 39564 |
| Type | Status | Filed Date | Description |
|---|---|---|---|
| Admin Dissolution | Filed | 2020-11-27 | Action of CEDAR LAKE MEDICAL CENTER, P.A.: AR |
| Notice to Dissolve/Revoke | Filed | 2020-08-28 | Notice to Dissolve/Revoke |
| Annual Report | Filed | 2019-06-25 | Annual Report For CEDAR LAKE MEDICAL CENTER, P.A. |
| Annual Report | Filed | 2018-09-25 | Annual Report For CEDAR LAKE MEDICAL CENTER, P.A. |
| Notice to Dissolve/Revoke | Filed | 2018-09-07 | Notice to Dissolve/Revoke |
| Annual Report | Filed | 2017-03-15 | Annual Report For CEDAR LAKE MEDICAL CENTER, P.A. |
| Annual Report | Filed | 2016-02-09 | Annual Report For CEDAR LAKE MEDICAL CENTER, P.A. |
| Annual Report | Filed | 2015-04-06 | Annual Report For CEDAR LAKE MEDICAL CENTER, P.A. |
| Annual Report | Filed | 2014-06-19 | Annual Report |
| Annual Report | Filed | 2013-06-27 | Annual Report |
Date of last update: 24 Dec 2024
Sources: Mississippi Secretary of State
