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  5. KING'S DAUGHTERS MEDICAL CENTER

KING'S DAUGHTERS MEDICAL CENTER

Company Details

Name: KING'S DAUGHTERS MEDICAL CENTER
Jurisdiction: MISSISSIPPI
Business Type: Non Profit Corporation
Status: Good Standing
Effective Date: 14 Oct 1914 (111 years ago)
Business ID: 665588
ZIP code: 39601
County: Lincoln
State of Incorporation: MISSISSIPPI
Principal Office Address: 427 Highway 51 NorthBrookhaven, MS 39601

Agent

Name Role Address
Scott Christensen Agent 427 Highway 51 North, Brookhaven, MS 39601

Incorporator

Name Role Address
Mary Bowen Incorporator B, Brookhaven, MS
Mary Hartman Incorporator B, Brookhaven, MS
Mary McNair Incorporator B, Brookhaven, MS

Director

Name Role Address
William O. Jacobs Director 1858 E. Lincoln Rd. SE, Brookhaven, MS 39601
Cathy Ditcharo Director 46 Eola Trail NE, Brookhaven, MS 39601
Sarah Foster Director 727 W. Chippewa, Brookhaven, MS 39601
Robyn Aker Director 422 Margaret St., Brookhaven, MS 39601
Joshua Iles Director 2581 Warren Rd. SE, Brookhaven, MS 39601
Sherra Smith Director 1816 Smith Lake Rd NE, Brookhaven, MS 39601
Sylvia Campbell Director 2139 Campbell Lane NW, Brookhaven, MS 39601
Ryan Case Director 307 Natchez Ave., Brookhaven, MS 39601
Michael Tanner Director 300 Truvillion Trl. NE, Brookhaven, MS 39601
Clint Gardner Director P.O. Box 1163, Brookhaven, MS 39601

Treasurer

Name Role Address
William O. Jacobs Treasurer 1858 E. Lincoln Rd. SE, Brookhaven, MS 39601

Secretary

Name Role Address
Cathy Ditcharo Secretary 46 Eola Trail NE, Brookhaven, MS 39601

Chief Executive Officer

Name Role Address
Scott Christensen Chief Executive Officer 427 Highway 51 N, Brookhaven, MS 39601

Chief Financial Officer

Name Role Address
Adam Moore Chief Financial Officer 427 HWY 51 N, Brookhaven, MS 39601

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:
GCMGYSNBELH4
CAGE Code:
5AHN1
UEI Expiration Date:
2026-05-01

Business Information

Activation Date:
2025-05-05
Initial Registration Date:
2009-01-13

National Provider Identifier

NPI Number:
1275307902
Certification Date:
2023-11-13
Link:
View on NPI website

Authorized Person:

Name:
SCOTT CHRISTENSEN
Role:
CEO
Phone:
6018359488

Taxonomy:

Selected Taxonomy:
261QR1300X - Rural Health Clinic/Center
Is Primary:
Yes

Contacts:

Phone:
+1 601-835-9275
Phone:
+1 601-823-5204

Form 5500 Series

Employer Identification Number (EIN):
640333594
Plan Year:
2023
Number Of Participants:
314
Sponsors Telephone Number:
6018359488
File:
View File
Plan Year:
2021
Number Of Participants:
509
Sponsors Telephone Number:
6018359488
File:
View File
Plan Year:
2021
Number Of Participants:
475
Sponsors Telephone Number:
6018359488
File:
View File
Plan Year:
2021
Number Of Participants:
509
Sponsors Telephone Number:
6018359488
Plan Year:
2020
Number Of Participants:
535
Sponsors Telephone Number:
6018336011
File:
View File

Filings

Type Status Filed Date Description
Amendment Form Filed 2024-09-30 Amendment For KING'S DAUGHTERS MEDICAL CENTER
Non-Profit Status Report Filed 2023-10-02 Status Report For KING'S DAUGHTERS MEDICAL CENTER
Non-Profit Status Report Filed 2023-08-08 Status Report For KING'S DAUGHTERS MEDICAL CENTER
Non-Profit Status Report Filed 2023-06-06 Status Report For KING'S DAUGHTERS MEDICAL CENTER
Amendment Form Filed 2023-03-10 Amendment For KING'S DAUGHTERS MEDICAL CENTER
Reinstatement Tax Filed 2023-03-09 Tax Clearance Letter
Non-Profit Status Report Filed 2022-10-06 Status Report For KING'S DAUGHTERS MEDICAL CENTER
Non-Profit Status Report Filed 2022-05-03 Status Report For KING'S DAUGHTERS MEDICAL CENTER
Non-Profit Status Report Filed 2021-10-08 Status Report For KING'S DAUGHTERS MEDICAL CENTER
Non-Profit Status Report Filed 2021-03-04 Status Report For KING'S DAUGHTERS MEDICAL CENTER

USAspending Awards / Contracts

Procurement Instrument Identifier:
W9127Q15P0071
Link:
View Award on USAspending website
Award Or Idv Flag:
AWARD
Award Type:
PURCHASE ORDER
Action Obligation:
4500.00
Base And Exercised Options Value:
4500.00
Base And All Options Value:
4500.00
Awarding Agency Name:
Department of Defense
Performance Start Date:
2015-07-25
Description:
IGF::CT::IGF KIDS SPORTS TRAINING
Naics Code:
622110: GENERAL MEDICAL AND SURGICAL HOSPITALS
Product Or Service Code:
G003: SOCIAL- RECREATIONAL
Procurement Instrument Identifier:
DJBP0102LB210018
Link:
View Award on USAspending website
Award Or Idv Flag:
AWARD
Award Type:
PO
Action Obligation:
50000.00
Base And Exercised Options Value:
50000.00
Base And All Options Value:
50000.00
Awarding Agency Name:
Department of Justice
Performance Start Date:
2012-03-26
Description:
''IGF::OT::IGF'' EMERGENCY MEDICAL SERVICE
Naics Code:
622110: GENERAL MEDICAL AND SURGICAL HOSPITALS
Product Or Service Code:
B537: SPECIAL STUDIES/ANALYSIS- MEDICAL/HEALTH

USAspending Awards / Financial Assistance

Date:
2022-09-29
Link:
View on USAspending
Awarding Agency Name:
Department of Agriculture
Transaction Description:
DIRECT COMMUNITY FACILITY LOANS
Obligated Amount:
0.00
Face Value Of Loan:
-9800000.00
Total Face Value Of Loan:
0.00
Date:
2022-09-29
Link:
View on USAspending
Awarding Agency Name:
Department of Agriculture
Transaction Description:
DIRECT COMMUNITY FACILITY LOANS
Obligated Amount:
0.00
Face Value Of Loan:
-3946000.00
Total Face Value Of Loan:
0.00
Date:
2022-09-29
Link:
View on USAspending
Awarding Agency Name:
Department of Agriculture
Transaction Description:
DIRECT COMMUNITY FACILITY LOANS
Obligated Amount:
0.00
Face Value Of Loan:
-9999000.00
Total Face Value Of Loan:
0.00
Date:
2022-09-29
Link:
View on USAspending
Awarding Agency Name:
Department of Agriculture
Transaction Description:
DIRECT COMMUNITY FACILITY LOANS
Obligated Amount:
0.00
Face Value Of Loan:
9700000.00
Total Face Value Of Loan:
0.00
Date:
2022-09-29
Link:
View on USAspending
Awarding Agency Name:
Department of Agriculture
Transaction Description:
GUARANTEED COMMUNITY FACILITY LOAN
Obligated Amount:
0.00
Face Value Of Loan:
4000000.00
Total Face Value Of Loan:
4000000.00

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Related by address

427 Highway 51 NorthBrookhaven, MS 39601

South Mississippi Wound Management, LLC

Date of last update: 02 May 2025

Sources: Company Profile on Mississippi Secretary of State Website

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