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  5. PERRY COUNTY GENERAL HOSPITAL, LLC

PERRY COUNTY GENERAL HOSPITAL, LLC

Company Details

Name: PERRY COUNTY GENERAL HOSPITAL, LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Dissolved
Effective Date: 12 Aug 2002 (23 years ago)
Business ID: 721185
ZIP code: 39476
County: Perry
State of Incorporation: MISSISSIPPI
Principal Office Address: 206 Bay Avenue, P.O. Box 1665Richton, MS 39476

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PERRY COUNTY GENERAL HOSPITAL, LLC 401(K) PLAN 2019 820560263 2020-02-18 PERRY COUNTY GENERAL HOSPITAL 48
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 622000
Sponsor’s telephone number 6017886316
Plan sponsor’s address PO BOX 1665, RICHTON, MS, 39476
PERRY COUNTY GENERAL HOSPITAL, LLC 401(K) PLAN AND TRUST 2014 820560263 2015-06-25 PERRY COUNTY GENERAL HOSPITAL, LLC 67
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 622000
Sponsor’s telephone number 6017886316
Plan sponsor’s address P. O. BOX 1665, RICHTON, MS, 39476

Signature of
Role Plan administrator
Date 2015-06-25
Name of individual signing DONALD BRADFORD
Valid signature Filed with authorized/valid electronic signature
PERRY COUNTY GENERAL HOSPITAL, LLC 401(K) PLAN AND TRUST 2014 820560263 2015-12-18 PERRY COUNTY GENERAL HOSPITAL, LLC 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 622000
Sponsor’s telephone number 6017886316
Plan sponsor’s address P. O. BOX 1665, RICHTON, MS, 39476

Signature of
Role Plan administrator
Date 2015-12-18
Name of individual signing DONALD BRADFORD
Valid signature Filed with authorized/valid electronic signature
PERRY COUNTY GENERAL HOSPITAL, LLC 401(K) PLAN AND TRUST 2013 820560263 2014-07-21 PERRY COUNTY GENERAL HOSPITAL, LLC 64
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 622000
Sponsor’s telephone number 6017886316
Plan sponsor’s address P. O. BOX 1665, RICHTON, MS, 39476

Signature of
Role Plan administrator
Date 2014-07-21
Name of individual signing DONALD BRADFORD
Valid signature Filed with authorized/valid electronic signature
PERRY COUNTY GENERAL HOSPITAL, LLC 401(K) PLAN AND TRUST 2012 820560263 2013-07-16 PERRY COUNTY GENERAL HOSPITAL, LLC 69
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 622000
Sponsor’s telephone number 6017886316
Plan sponsor’s address P. O. BOX 1665, RICHTON, MS, 39476

Signature of
Role Plan administrator
Date 2013-07-16
Name of individual signing DONALD BRADFORD
Valid signature Filed with authorized/valid electronic signature
PERRY COUNTY GENERAL HOSPITAL, LLC 401(K) PLAN AND TRUST 2011 820560263 2012-04-26 PERRY COUNTY GENERAL HOSPITAL, LLC 70
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 622000
Sponsor’s telephone number 6017886316
Plan sponsor’s address P. O. BOX 1665, RICHTON, MS, 39476

Plan administrator’s name and address
Administrator’s EIN 820560263
Plan administrator’s name PERRY COUNTY GENERAL HOSPITAL, LLC
Plan administrator’s address P. O. BOX 1665, RICHTON, MS, 39476
Administrator’s telephone number 6017886316

Signature of
Role Plan administrator
Date 2012-04-26
Name of individual signing DONALD BRADFORD
Valid signature Filed with authorized/valid electronic signature
PERRY COUNTY GENERAL HOSPITAL, LLC 401(K) PLAN AND TRUST 2010 820560263 2011-03-08 PERRY COUNTY GENERAL HOSPITAL, LLC 83
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 622000
Sponsor’s telephone number 6017886316
Plan sponsor’s address P. O. BOX 1665, RICHTON, MS, 39476

Plan administrator’s name and address
Administrator’s EIN 820560263
Plan administrator’s name PERRY COUNTY GENERAL HOSPITAL, LLC
Plan administrator’s address P. O. BOX 1665, RICHTON, MS, 39476
Administrator’s telephone number 6017886316

Signature of
Role Plan administrator
Date 2011-03-08
Name of individual signing DONALD BRADFORD
Valid signature Filed with authorized/valid electronic signature
PERRY COUNTY GENERAL HOSPITAL, LLC 401(K) PLAN AND TRUST 2009 820560263 2010-07-06 PERRY COUNTY GENERAL HOSPITAL, LLC 75
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 622000
Sponsor’s telephone number 6017886316
Plan sponsor’s address P. O. BOX 1665, RICHTON, MS, 39476

Plan administrator’s name and address
Administrator’s EIN 820560263
Plan administrator’s name PERRY COUNTY GENERAL HOSPITAL, LLC
Plan administrator’s address P. O. BOX 1665, RICHTON, MS, 39476
Administrator’s telephone number 6017886316

Signature of
Role Plan administrator
Date 2010-07-06
Name of individual signing DONALD BRADFORD
Valid signature Filed with authorized/valid electronic signature
PERRY COUNTY GENERAL HOSPITAL, LLC 401(K) PLAN AND TRUST 2009 820560263 2010-07-06 PERRY COUNTY GENERAL HOSPITAL, LLC 75
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 622000
Sponsor’s telephone number 6017886316
Plan sponsor’s address P. O. BOX 1665, RICHTON, MS, 39476

Plan administrator’s name and address
Administrator’s EIN 820560263
Plan administrator’s name PERRY COUNTY GENERAL HOSPITAL, LLC
Plan administrator’s address P. O. BOX 1665, RICHTON, MS, 39476
Administrator’s telephone number 6017886316

Signature of
Role Plan administrator
Date 2010-07-06
Name of individual signing DONALD BRADFORD
Valid signature Filed with incorrect/unrecognized electronic signature
PERRY COUNTY GENERAL HOSPITAL, LLC 401(K) PLAN AND TRUST 2009 820560263 2010-06-30 PERRY COUNTY GENERAL HOSPITAL, LLC 75
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 622000
Sponsor’s telephone number 6017886316
Plan sponsor’s address P. O. BOX 1665, RICHTON, MS, 39476

Plan administrator’s name and address
Administrator’s EIN 820560263
Plan administrator’s name PERRY COUNTY GENERAL HOSPITAL, LLC
Plan administrator’s address P. O. BOX 1665, RICHTON, MS, 39476
Administrator’s telephone number 6017886316

Signature of
Role Plan administrator
Date 2010-06-30
Name of individual signing DONALD BRADFORD
Valid signature Filed with incorrect/unrecognized electronic signature

Manager

Name Role Address
John David Paris Manager 21 Pleasant Valley Drive, Petal, MS 39465
Donald L Bradford Manager 113 Wildwood Trail, Petal, MS 39465
JOHN DAVID PARIS Manager 21 Pleasant Valley Drive, Petal, MS 39465

Member

Name Role Address
John David Paris Member 21 Pleasant Valley Drive, Petal, MS 39465
Donald L Bradford Member 113 Wildwood Trail, Petal, MS 39465
JOHN DAVID PARIS Member 21 Pleasant Valley Drive, Petal, MS 39465

President

Name Role Address
John David Paris President 21 Pleasant Valley Drive, Petal, MS 39465
JOHN DAVID PARIS President 21 Pleasant Valley Drive, Petal, MS 39465

Secretary

Name Role Address
Donald L Bradford Secretary 113 Wildwood Trail, Petal, MS 39465

Treasurer

Name Role Address
Donald L Bradford Treasurer 113 Wildwood Trail, Petal, MS 39465

Vice President

Name Role Address
Donald L Bradford Vice President 113 Wildwood Trail, Petal, MS 39465

Agent

Name Role Address
JOHN DAVID PARIS Agent 206 BAY AVENUE, P O BOX 1665, RICHTON, MS 39476

Filings

Type Status Filed Date Description
Dissolution Filed 2025-01-28 Dissolution For PERRY COUNTY GENERAL HOSPITAL, LLC
Annual Report LLC Filed 2024-02-15 Annual Report For PERRY COUNTY GENERAL HOSPITAL, LLC
Annual Report LLC Filed 2023-02-14 Annual Report For PERRY COUNTY GENERAL HOSPITAL, LLC
Annual Report LLC Filed 2022-02-28 Annual Report For PERRY COUNTY GENERAL HOSPITAL, LLC
Annual Report LLC Filed 2021-03-24 Annual Report For PERRY COUNTY GENERAL HOSPITAL, LLC
Annual Report LLC Filed 2020-01-08 Annual Report For PERRY COUNTY GENERAL HOSPITAL, LLC
Annual Report LLC Filed 2019-02-20 Annual Report For PERRY COUNTY GENERAL HOSPITAL, LLC
Annual Report LLC Filed 2018-01-26 Annual Report For PERRY COUNTY GENERAL HOSPITAL, LLC
Annual Report LLC Filed 2017-02-16 Annual Report For PERRY COUNTY GENERAL HOSPITAL, LLC
Annual Report LLC Filed 2016-03-25 Annual Report For PERRY COUNTY GENERAL HOSPITAL, LLC

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
5887758300 2021-01-26 0470 PPS 206 Bay Ave, Richton, MS, 39476-2941
Loan Status Date 2021-09-15
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 621040
Loan Approval Amount (current) 621040
Undisbursed Amount 0
Franchise Name -
Lender Location ID 39217
Servicing Lender Name Community Bank of Mississippi
Servicing Lender Address 1905, Community Bank Way, Flowood, MS, 39232
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Richton, PERRY, MS, 39476-2941
Project Congressional District MS-04
Number of Employees 69
NAICS code 621111
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Corporation
Originating Lender ID 39217
Originating Lender Name Community Bank of Mississippi
Originating Lender Address Flowood, MS
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 624340.87
Forgiveness Paid Date 2021-08-11
6460337008 2020-04-07 0470 PPP 296 BAY AVE, RICHTON, MS, 39476-2941
Loan Status Date 2021-01-07
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 621000
Loan Approval Amount (current) 621000
Undisbursed Amount 0
Franchise Name -
Lender Location ID 39217
Servicing Lender Name Community Bank of Mississippi
Servicing Lender Address 1905, Community Bank Way, Flowood, MS, 39232
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address RICHTON, PERRY, MS, 39476-2941
Project Congressional District MS-04
Number of Employees 65
NAICS code 622110
Borrower Race White
Borrower Ethnicity Not Hispanic or Latino
Business Type Corporation
Originating Lender ID 39217
Originating Lender Name Community Bank of Mississippi
Originating Lender Address Flowood, MS
Gender Male Owned
Veteran Non-Veteran
Forgiveness Amount 625032.25
Forgiveness Paid Date 2020-12-04

Related by officers

John David Paris

LEAF RIVER HEALTH CARE ASSOCIATES, LLC Leaf River Excavating LLC Perry Investment Group, LLC

Donald L Bradford

LEAF RIVER HEALTH CARE ASSOCIATES, LLC Leaf River Trucking, LLC Perry Investment Group, LLC

JOHN DAVID PARIS

LEAF RIVER HEALTH CARE ASSOCIATES, LLC

Related by address

No related companies by address

Date of last update: 19 Mar 2025

Sources: Mississippi Secretary of State

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