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Magnolia State Family Medicine, LLC

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Company Details

Name: Magnolia State Family Medicine, LLC
Jurisdiction: MISSISSIPPI
Business Type: Limited Liability Company
Status: Dissolved
Effective Date: 20 Jul 2007 (18 years ago)
Business ID: 916052
ZIP code: 38663
County: Tippah
State of Incorporation: MISSISSIPPI
Principal Office Address: 1009B CITY AVENUE NORTHRIPLEY, MS 38663

Agent

Name Role Address
Christopher Cummins Agent 81 CR 849, Blue Mountain, MS 38610

Manager

Name Role Address
Christopher J M Cummins Manager 1009B CITY AVENUE NORTH, RIPLEY, MS 38663

Member

Name Role Address
Christopher J. M. Cummins Member 1009B City Avenue North, Ripley, MS 38663
Christopher J M Cummins Member 1009B CITY AVENUE NORTH, RIPLEY, MS 38663
S. E. Donald, CPA Member 1417 Trailwood DriveP.O. Box 5546, Greenville, MS 38701

National Provider Identifier

NPI Number:
1891988788

Authorized Person:

Name:
DR. CHRISTOPHER J.M. CUMMINS, MD
Role:
MD/OWNER
Phone:

Taxonomy:

Selected Taxonomy:
208D00000X - General Practice Physician
Is Primary:
Yes

Contacts:

Fax:
6629939459

Form 5500 Series

Employer Identification Number (EIN):
260542139
Plan Year:
2012
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
3
Sponsors Telephone Number:

Filings

Type Status Filed Date Description
Admin Dissolution Filed 2016-11-30 Admin Dissolution
Notice to Dissolve/Revoke Filed 2016-09-06 Notice to Dissolve/Revoke
Amendment Form Filed 2015-08-10 Amendment For Magnolia State Family Medicine, LLC
Annual Report LLC Filed 2015-02-28 Annual Report For Magnolia State Family Medicine, LLC
Annual Report LLC Filed 2014-03-14 Annual Report LLC
Annual Report LLC Filed 2013-01-22 Annual Report LLC
Annual Report LLC Filed 2012-10-17 Annual Report LLC
Notice to Dissolve/Revoke Filed 2012-09-14 Notice to Dissolve/Revoke
Reinstatement Filed 2012-07-10 Reinstatement
Amendment Form Filed 2012-07-10 Amendment

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Date of last update: 07 May 2025

Sources: Company Profile on Mississippi Secretary of State Website