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  5. MedPay Assurance, LLC

MedPay Assurance, LLC

Headquarter

Company Details

Name: MedPay Assurance, LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Dissolved
Effective Date: 21 Dec 2005 (19 years ago)
Business ID: 883477
ZIP code: 38834
County: Alcorn
State of Incorporation: MISSISSIPPI
Principal Office Address: 602 EAST WALDRONCORINTH, MS 38834

Links between entities

Type Company Name Company Number State
Headquarter of MedPay Assurance, LLC, ALABAMA 000-620-096 ALABAMA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MEDPAY ASSURANCE, LLC 401(K) P/S PLAN 2012 020769842 2013-02-08 MEDPAY ASSURANCE, LLC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 488510
Sponsor’s telephone number 6622866595
Plan sponsor’s address 602 E WALDRON ST, CORINTH, MS, 388344863

Signature of
Role Plan administrator
Date 2013-02-08
Name of individual signing TIM SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-02-08
Name of individual signing TIM SMITH
Valid signature Filed with authorized/valid electronic signature
MEDPAY ASSURANCE, LLC 401(K) P/S PLAN 2011 020769842 2012-07-16 MEDPAY ASSURANCE, LLC 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 488510
Sponsor’s telephone number 6622866595
Plan sponsor’s address 602 E WALDRON ST, CORINTH, MS, 388344863

Plan administrator’s name and address
Administrator’s EIN 020769842
Plan administrator’s name MEDPAY ASSURANCE, LLC
Plan administrator’s address 602 E WALDRON ST, CORINTH, MS, 388344863
Administrator’s telephone number 6622866595

Signature of
Role Plan administrator
Date 2012-07-16
Name of individual signing TIM SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-16
Name of individual signing TIM SMITH
Valid signature Filed with authorized/valid electronic signature
MEDPAY ASSURANCE, LLC 401(K) P/S PLAN 2010 020769842 2011-07-21 MEDPAY ASSURANCE, LLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 488510
Sponsor’s telephone number 6622866595
Plan sponsor’s address 602 E WALDRON ST, CORINTH, MS, 388344863

Plan administrator’s name and address
Administrator’s EIN 020769842
Plan administrator’s name MEDPAY ASSURANCE, LLC
Plan administrator’s address 602 E WALDRON ST, CORINTH, MS, 388344863
Administrator’s telephone number 6622866595

Signature of
Role Plan administrator
Date 2011-07-21
Name of individual signing TIM SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-21
Name of individual signing TIM SMITH
Valid signature Filed with authorized/valid electronic signature
MEDPAY ASSURANCE, LLC 401(K) P/S PLAN 2010 020769842 2011-07-14 MEDPAY ASSURANCE, LLC 11
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 488510
Sponsor’s telephone number 6622866595
Plan sponsor’s address 602 E WALDRON ST, CORINTH, MS, 388344863

Plan administrator’s name and address
Administrator’s EIN 020769842
Plan administrator’s name MEDPAY ASSURANCE, LLC
Plan administrator’s address 602 E WALDRON ST, CORINTH, MS, 388344863
Administrator’s telephone number 6622866595

Signature of
Role Plan administrator
Date 2011-07-14
Name of individual signing TIM SMITH
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2011-07-14
Name of individual signing TIM SMITH
Valid signature Filed with incorrect/unrecognized electronic signature
MEDPAY ASSURANCE, LLC 401(K) P/S PLAN 2009 020769842 2010-07-16 MEDPAY ASSURANCE, LLC 7
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 541190
Sponsor’s telephone number 6019142977
Plan sponsor’s address 602 EAST WALDRON, CORINTH, MS, 38834

Plan administrator’s name and address
Administrator’s EIN 020769842
Plan administrator’s name MEDPAY ASSURANCE, LLC
Plan administrator’s address 602 EAST WALDRON, CORINTH, MS, 38834
Administrator’s telephone number 6019142977

Signature of
Role Plan administrator
Date 2010-07-16
Name of individual signing BRAD WILLIAMS
Valid signature Filed with incorrect/unrecognized electronic signature
MEDPAY ASSURANCE, LLC 401(K) P/S PLAN 2009 020769842 2010-07-16 MEDPAY ASSURANCE, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 541190
Sponsor’s telephone number 6019142977
Plan sponsor’s address 602 EAST WALDRON, CORINTH, MS, 38834

Plan administrator’s name and address
Administrator’s EIN 020769842
Plan administrator’s name MEDPAY ASSURANCE, LLC
Plan administrator’s address 602 EAST WALDRON, CORINTH, MS, 38834
Administrator’s telephone number 6019142977

Signature of
Role Plan administrator
Date 2010-07-16
Name of individual signing BRAD WILLIAMS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Smith, Tim Agent 602 East Waldron Street, Corinth, MS 38834

Member

Name Role Address
Tim B. Smith Member 105 S. Main St.PO Box 606, Booneville, MS 38829
Brad M Williams Member 540 Keyway Drive, Flowood, MS 39232
Tim Smith Member 602 EAST WALDRON, CORINTH, MS 38834

Filings

Type Status Filed Date Description
Admin Dissolution Filed 2013-10-01 Admin Dissolution
Notice to Dissolve/Revoke Filed 2013-07-01 Notice to Dissolve/Revoke
Annual Report LLC Filed 2012-10-12 Annual Report LLC
Notice to Dissolve/Revoke Filed 2012-09-14 Notice to Dissolve/Revoke
Annual Report LLC Filed 2011-03-29 Annual Report LLC
Amendment Form Filed 2009-07-14 Amendment
Formation Form Filed 2005-12-21 Formation

Related by officers

Smith, Tim

Smith Bailey Realty, LLC Smith Property Holdings, LLC

Brad M Williams

DRP Masonry LLC Maison Home Builders, LLC Gressett Williams Capital LLC

Tim Smith

Electric Cooperatives of Mississippi (A.A.L.) TC Investments, Inc. First Choice Mortgage Services, L.L.C. Cedar Ridge Condominium Association Inc. RED, Inc. Cascade Holding Corporation Avectus Healthcare Solutions, LLC American Green Technology Inc Advanced Technical Services LLC L & G Property Holdings, LLC

Related by address

No related companies by address

Date of last update: 31 Dec 2024

Sources: Mississippi Secretary of State

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