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NORTH CENTRAL MISSISSIPPI REGIONAL CANCER CENTER, INC.

NORTH CENTRAL MISSISSIPPI REGIONAL CANCER CENTER, INC.

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Company Details

Name:	NORTH CENTRAL MISSISSIPPI REGIONAL CANCER CENTER, INC.
Jurisdiction:	MISSISSIPPI
Business Type:	Profit Corporation
Status:	Dissolved
Effective Date:	15 Jan 2003 (22 years ago)
Business ID:	727879
ZIP code:	39202
County:	Hinds
State of Incorporation:	MISSISSIPPI
Principal Office Address:	764 Gillespie StJackson, MS 39202

Agent

Name	Role	Address
Smith, Mary K	Agent	764 Gillespie St, Jackson, MS 39202

Incorporator

Name	Role	Address
Norman P Jeddeloh	Incorporator	120 S Riverside Plaza #1200, Chicago, IL 60606

President

Name	Role	Address
Arnold B Smith	President	2470 N Candlewood Dr, Fayetteville, AR 72703
Jennifer Welch	President	935 Bellevue Place, Jackson, MS 39202

Director

Name	Role	Address
Jennifer Welch	Director	935 Bellevue Place, Jackson, MS 39202
Mary K Smith	Director	764 Gillespie St, Jackson, MS 39202
Arnold B Smith	Director	2470 N Candlewood Dr, Fayetteville, AR 72703

Secretary

Name	Role	Address
Mary K Smith	Secretary	764 Gillespie St, Jackson, MS 39202

Treasurer

Name	Role	Address
Mary K Smith	Treasurer	764 Gillespie St, Jackson, MS 39202

National Provider Identifier

NPI Number:

1275645798

Link:

View on NPI website

Authorized Person:

Name:

MR. MADISON WILSON GAILLARD III

Role:

ADMINISTRATOR

Phone:

6624597133

Taxonomy:

Selected Taxonomy:

2085R0001X - Radiation Oncology Physician

Is Primary:

Yes

Contacts:

Phone:

+1 662-459-7133

Fax:

6624597136

Form 5500 Series

Employer Identification Number (EIN):

470911949

Plan Year:

2013

Number Of Participants:

Sponsors Telephone Number:

6624597133

File:

View File

Filings

Type	Status	Filed Date	Description
Dissolution	Filed	2021-10-05	Dissolution For NORTH CENTRAL MISSISSIPPI REGIONAL CANCER CENTER, INC.
Notice to Dissolve/Revoke	Filed	2021-09-07	Notice of Intent to Dissolve: AR: NORTH CENTRAL MISSISSIPPI REGIONAL CANCER CENTER, INC.
Annual Report	Filed	2020-02-14	Annual Report For NORTH CENTRAL MISSISSIPPI REGIONAL CANCER CENTER, INC.
Annual Report	Filed	2019-03-05	Annual Report For NORTH CENTRAL MISSISSIPPI REGIONAL CANCER CENTER, INC.
Annual Report	Filed	2018-03-20	Annual Report For NORTH CENTRAL MISSISSIPPI REGIONAL CANCER CENTER, INC.
Annual Report	Filed	2017-02-21	Annual Report For NORTH CENTRAL MISSISSIPPI REGIONAL CANCER CENTER, INC.
Annual Report	Filed	2016-02-03	Annual Report For NORTH CENTRAL MISSISSIPPI REGIONAL CANCER CENTER, INC.
Annual Report	Filed	2015-03-19	Annual Report For NORTH CENTRAL MISSISSIPPI REGIONAL CANCER CENTER, INC.
Annual Report	Filed	2014-03-17	Annual Report
Amendment Form	Filed	2014-03-10	Amendment

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Date of last update: 05 May 2025

Sources: Company Profile on Mississippi Secretary of State Website