|
FIRST CHOICE MEDICAL SUPPLY
|
2015
|
481262424
|
2016-07-08
|
FIRST CHOICE MEDICAL SUPPLY, LLC
|
200
|
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2015-03-01
|
| Business code |
423990
|
| Plan sponsor’s mailing address |
127 INTERSTATE DR, RICHLAND, MS, 392189485
|
| Plan sponsor’s
address |
127 INTERSTATE DR, RICHLAND, MS, 392189485
|
Number of participants as of the end of the plan year
Signature of
| Role |
Plan administrator |
| Date |
2016-07-06 |
| Name of individual signing |
STACEY HOLT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
FIRST CHOICE MEDICAL SUPPLY
|
2015
|
481262424
|
2016-08-19
|
FIRST CHOICE MEDICAL SUPPLY, LLC
|
237
|
|
| Three-digit plan number (PN) |
504
|
| Effective date of plan |
2013-03-01
|
| Business code |
621610
|
| Sponsor’s telephone number |
6013527878
|
| Plan sponsor’s mailing address |
127 INTERSTATE DR, RICHLAND, MS, 392189485
|
| Plan sponsor’s
address |
127 INTERSTATE DR, RICHLAND, MS, 392189485
|
Number of participants as of the end of the plan year
Signature of
| Role |
Plan administrator |
| Date |
2016-08-19 |
| Name of individual signing |
STACEY HOLT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
FIRST CHOICE MEDICAL SUPPLY, LLC DENTAL PLAN
|
2015
|
481262424
|
2016-08-19
|
FIRST CHOICE MEDICAL SUPPLY, LLC
|
187
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
503
|
| Effective date of plan |
2012-06-01
|
| Business code |
621610
|
| Sponsor’s telephone number |
6013527878
|
| Plan sponsor’s mailing address |
127 INTERSTATE DR, RICHLAND, MS, 392189485
|
| Plan sponsor’s
address |
127 INTERSTATE DR, RICHLAND, MS, 392189485
|
Plan administrator’s name and address
| Administrator’s EIN |
350672425 |
| Plan administrator’s name |
FOX EVERETT A DIVISION OF HUB INTER |
| Plan administrator’s
address |
PO BOX 6006, RIDGELAND, MS, 391586006 |
Number of participants as of the end of the plan year
Signature of
| Role |
Plan administrator |
| Date |
2016-08-19 |
| Name of individual signing |
STACEY HOLT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
FIRST CHOICE MEDICAL SUPPLY
|
2015
|
481262424
|
2016-08-19
|
FIRST CHOICE MEDICAL SUPPLY, LLC
|
149
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
503
|
| Effective date of plan |
2011-03-01
|
| Business code |
621610
|
| Sponsor’s telephone number |
6013527878
|
| Plan sponsor’s mailing address |
127 INTERSTATE DR, RICHLAND, MS, 392189485
|
| Plan sponsor’s
address |
127 INTERSTATE DR, RICHLAND, MS, 392189485
|
Number of participants as of the end of the plan year
Signature of
| Role |
Plan administrator |
| Date |
2016-08-19 |
| Name of individual signing |
STACEY HOLT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
FIRST CHOICE MEDICAL SUPPLY, LLC DENTAL PLAN
|
2015
|
481262424
|
2016-08-19
|
FIRST CHOICE MEDICAL SUPPLY, LLC
|
187
|
|
| Three-digit plan number (PN) |
502
|
| Effective date of plan |
2012-06-01
|
| Business code |
621610
|
| Sponsor’s telephone number |
6013527878
|
| Plan sponsor’s mailing address |
127 INTERSTATE DR, RICHLAND, MS, 392189485
|
| Plan sponsor’s
address |
127 INTERSTATE DR, RICHLAND, MS, 392189485
|
Number of participants as of the end of the plan year
Signature of
| Role |
Plan administrator |
| Date |
2016-08-19 |
| Name of individual signing |
STACEY HOLT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
FIRST CHOICE MEDICAL SUPPLY LLC
|
2012
|
481262424
|
2016-07-27
|
FIRST CHOICE MEDICAL SUPPLY LLC
|
170
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
504
|
| Effective date of plan |
2012-03-01
|
| Business code |
423990
|
| Sponsor’s telephone number |
6013527878
|
| Plan sponsor’s mailing address |
P.O. BOX 22769, JACKSON, MS, 39225
|
| Plan sponsor’s
address |
127 INTERSTATE DRIVE, RICHLAND, MS, 39218
|
Number of participants as of the end of the plan year
Signature of
| Role |
Plan administrator |
| Date |
2016-07-25 |
| Name of individual signing |
STACEY HOLT |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
