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  5. TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C.

TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C.

Company Details

Name: TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 09 Jun 1988 (37 years ago)
Entity Number: 1268282
ZIP code: 14070
County: Cattaraugus
Place of Formation: New York
Address: 1 SCHOOL STREET, SUITE 107, GOWANDA, NY, United States, 14070

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C. 401(K) PLAN 2022 161338561 2023-10-05 TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 7162417067
Plan sponsor’s address 1 SCHOOL STREET, SUITE 107, GOWANDA, NY, 14070

Signature of
Role Plan administrator
Date 2023-10-05
Name of individual signing DANA ANDERSON
TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C. 401(K) PLAN 2022 161338561 2023-12-28 TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 7162417067
Plan sponsor’s address 1 SCHOOL ST STE 107, GOWANDA, NY, 140701143

Signature of
Role Plan administrator
Date 2023-12-28
Name of individual signing DANA ANDERSON
TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C. 401(K) PLAN 2021 161338561 2022-08-09 TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 7162417067
Plan sponsor’s address 1 SCHOOL STREET, SUITE 107, GOWANDA, NY, 14070

Signature of
Role Plan administrator
Date 2022-08-08
Name of individual signing DANA ANDERSON
TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C. 401(K) PLAN 2020 161338561 2021-09-16 TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 7162417067
Plan sponsor’s address 1 SCHOOL STREET, SUITE 107, GOWANDA, NY, 14070

Signature of
Role Plan administrator
Date 2021-09-16
Name of individual signing DANA ANDERSON
TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C. 401(K) PLAN 2019 161338561 2020-09-25 TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 7162417067
Plan sponsor’s address 1 SCHOOL STREET, SUITE 107, GOWANDA, NY, 14070

Signature of
Role Plan administrator
Date 2020-09-25
Name of individual signing DANA ANDERSON
TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C. 401(K) PLAN 2018 161338561 2019-07-01 TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 7162417067
Plan sponsor’s address 1 SCHOOL STREET, SUITE 107, GOWANDA, NY, 14070

Signature of
Role Plan administrator
Date 2019-07-01
Name of individual signing DANA ANDERSON
TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C. 401(K) PLAN 2017 161338561 2018-10-01 TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 7162417067
Plan sponsor’s address 1 SCHOOL STREET, SUITE 107, GOWANDA, NY, 14070

Signature of
Role Plan administrator
Date 2018-10-01
Name of individual signing DANA ANDERSON
TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C. 401(K) PLAN 2016 161338561 2017-09-01 TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 7162417067
Plan sponsor’s address 1 SCHOOL STREET, SUITE 107, GOWANDA, NY, 14070

Signature of
Role Plan administrator
Date 2017-09-01
Name of individual signing DANA ANDERSON
TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C. 401(K) PLAN 2015 161338561 2016-10-11 TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 7162417067
Plan sponsor’s address 1 SCHOOL STREET, SUITE 107, GOWANDA, NY, 14070

Signature of
Role Plan administrator
Date 2016-10-11
Name of individual signing DANA ANDERSON
TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C. 401(K) PLAN 2014 161338561 2015-09-01 TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 7162417067
Plan sponsor’s address 1 SCHOOL STREET, SUITE 107, GOWANDA, NY, 14070

Signature of
Role Plan administrator
Date 2015-09-01
Name of individual signing DANA ANDERSON

Chief Executive Officer

Name Role Address
JAMES E WILD, MD Chief Executive Officer 1 SCHOOL STREET, SUITE 107, GOWANDA, NY, United States, 14070

DOS Process Agent

Name Role Address
TRI-COUNTY FAMILY MEDICINE ASSOCIATES, P.C. DOS Process Agent 1 SCHOOL STREET, SUITE 107, GOWANDA, NY, United States, 14070

History

Start date End date Type Value
2010-06-24 2012-06-07 Address 10744 MAIN ST, PO BOX 388, NORTH COLLINS, NY, 14111, USA (Type of address: Principal Executive Office)
2010-06-24 2012-06-07 Address 10744 MAIN ST, PO BOX 388, NORTH COLLINS, NY, 14111, USA (Type of address: Service of Process)
2010-06-24 2012-06-07 Address 10744 MAIN ST, PO BOX 388, NORTH COLLINS, NY, 14111, USA (Type of address: Chief Executive Officer)
1993-02-03 2010-06-24 Address 104 MEMORIAL DRIVE, GOWANDA, NY, 14070, USA (Type of address: Chief Executive Officer)
1993-02-03 2010-06-24 Address 104 MEMORIAL DRIVE, GOWANDA, NY, 14070, USA (Type of address: Principal Executive Office)
1993-02-03 2010-06-24 Address 104 MEMORIAL DRIVE, GOWANDA, NY, 14070, USA (Type of address: Service of Process)
1991-04-30 1993-02-03 Address 100 MEMORIAL DRIVE, GOWANDA, NY, 14070, USA (Type of address: Service of Process)
1988-06-09 1991-04-30 Address 20 CATHEDRAL PARK, BUFFALO, NY, 14202, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
120607006151 2012-06-07 BIENNIAL STATEMENT 2012-06-01
100624003161 2010-06-24 BIENNIAL STATEMENT 2010-06-01
080702002497 2008-07-02 BIENNIAL STATEMENT 2008-06-01
060522002847 2006-05-22 BIENNIAL STATEMENT 2006-06-01
040706002428 2004-07-06 BIENNIAL STATEMENT 2004-06-01
020531002453 2002-05-31 BIENNIAL STATEMENT 2002-06-01
000601002705 2000-06-01 BIENNIAL STATEMENT 2000-06-01
980609002817 1998-06-09 BIENNIAL STATEMENT 1998-06-01
960619002437 1996-06-19 BIENNIAL STATEMENT 1996-06-01
930909002554 1993-09-09 BIENNIAL STATEMENT 1993-06-01

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 19 Dec 2024

Sources: New York Secretary of State

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