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MISSION PRIMARY CARE CLINIC, PLLC

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Company Details

Name: MISSION PRIMARY CARE CLINIC, PLLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Good Standing
Effective Date: 04 Nov 1998 (27 years ago)
Business ID: 663109
ZIP code: 39180
County: Warren
State of Incorporation: MISSISSIPPI
Principal Office Address: 1901 Mission 66, 1901 Mission 66Vicksburg, MS 39180

Agent

Name Role Address
R LEE GIFFIN Agent 1901 MISSION 66, VICKSBURG, MS 39180

Member

Name Role Address
R Lee Giffin Member 1901 MISSION 66, VICKSBURG, MS 39180

U.S. Small Business Administration Profile

The U.S. Small Business Administration (SBA) helps Americans start, grow, and build resilient businesses.

Note: SBA was created in 1953 as an independent agency of the federal government to aid, counsel, assist and protect the interests of small business concerns; preserve free competitive enterprise; and maintain and strengthen the overall economy of our nation. SBA reviews Congressional and testifies on behalf of small businesses. It assesses the impact of regulatory burden on small businesses.

Phone Number:
E-mail Address:
Contact Person:
WILLIAM FULCHER
Ownership and Self-Certifications:
Self-Certified Small Disadvantaged Business
User ID:
P3164284

Unique Entity ID

A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.

Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity doing business with the federal government must register for a UEI.

Unique Entity ID:
RH6SKAX3DMW9
CAGE Code:
1UA78
UEI Expiration Date:
2026-01-28

Business Information

Division Name:
MISSION PRIMARY CARE CLINIC PLLC
Activation Date:
2025-01-30
Initial Registration Date:
2001-06-13

National Provider Identifier

NPI Number:
1487852018
Certification Date:
2022-05-25

Authorized Person:

Name:
BILL FULCHER
Role:
ADM
Phone:

Taxonomy:

Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
6016299969

Form 5500 Series

Employer Identification Number (EIN):
640862084
Plan Year:
2023
Number Of Participants:
24
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
23
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
24
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
23
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
26
Sponsors Telephone Number:

Filings

Type Status Filed Date Description
Annual Report LLC Filed 2025-04-15 Annual Report For MISSION PRIMARY CARE CLINIC, PLLC
Annual Report LLC Filed 2024-01-23 Annual Report For MISSION PRIMARY CARE CLINIC, PLLC
Annual Report LLC Filed 2023-04-18 Annual Report For MISSION PRIMARY CARE CLINIC, PLLC
Annual Report LLC Filed 2023-03-09 Annual Report For MISSION PRIMARY CARE CLINIC, PLLC
Annual Report LLC Filed 2022-04-21 Annual Report For MISSION PRIMARY CARE CLINIC, PLLC
Annual Report LLC Filed 2021-04-12 Annual Report For MISSION PRIMARY CARE CLINIC, PLLC
Annual Report LLC Filed 2020-04-24 Annual Report For MISSION PRIMARY CARE CLINIC, PLLC
Annual Report LLC Filed 2019-04-15 Annual Report For MISSION PRIMARY CARE CLINIC, PLLC
Annual Report LLC Filed 2018-04-13 Annual Report For MISSION PRIMARY CARE CLINIC, PLLC
Annual Report LLC Filed 2017-03-28 Annual Report For MISSION PRIMARY CARE CLINIC, PLLC

USAspending Awards / Contracts

Procurement Instrument Identifier:
W912HZ24C0063
Award Or Idv Flag:
AWARD
Award Type:
DEFINITIVE CONTRACT
Action Obligation:
62400.00
Base And Exercised Options Value:
62400.00
Base And All Options Value:
343200.00
Awarding Agency Name:
Department of Defense
Performance Start Date:
2024-07-24
Description:
BASE YEAR - PHYSICIAN SERVICES
Naics Code:
621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product Or Service Code:
Q999: MEDICAL- OTHER
Procurement Instrument Identifier:
W912EE23P0089
Award Or Idv Flag:
AWARD
Award Type:
PURCHASE ORDER
Action Obligation:
99400.00
Base And Exercised Options Value:
99400.00
Base And All Options Value:
503000.00
Awarding Agency Name:
Department of Defense
Performance Start Date:
2023-08-18
Description:
PHYSICIAN SERVICES
Naics Code:
621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product Or Service Code:
Q201: MEDICAL- GENERAL HEALTH CARE
Procurement Instrument Identifier:
W912EE23P0090
Award Or Idv Flag:
AWARD
Award Type:
PURCHASE ORDER
Action Obligation:
7500.00
Base And Exercised Options Value:
7500.00
Base And All Options Value:
37500.00
Awarding Agency Name:
Department of Defense
Performance Start Date:
2023-08-18
Description:
LABORATORY BLOOD TESTING SERVICES FOR USACE-MVK.
Naics Code:
621511: MEDICAL LABORATORIES
Product Or Service Code:
Q301: MEDICAL- LABORATORY TESTING

USAspending Awards / Financial Assistance

Date:
2021-02-23
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
338570.00
Total Face Value Of Loan:
338570.00
Date:
2020-04-14
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
336007.50
Total Face Value Of Loan:
336007.50

OSHA's Inspections within Industry

Inspection Summary

Date:
2011-09-08
Type:
Planned
Address:
1901 MISSION 66, VICKSBURG, MS, 39180
Safety Health:
Health
Scope:
Complete

Paycheck Protection Program

Date Approved:
2021-02-23
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
338570
Current Approval Amount:
338570
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
341111.59
Date Approved:
2020-04-14
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
336007.5
Current Approval Amount:
336007.5
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
338704.89

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Date of last update: 02 May 2025

Sources: Company Profile on Mississippi Secretary of State Website