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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

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3768877303 2020-04-29 0296 PPP 1 School Street Suite 107, GOWANDA, NY, 14070
Loan Status Date 2021-07-16
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 204076.38
Loan Approval Amount (current) 204076.38
Undisbursed Amount 0
Franchise Name -
Lender Location ID 47029
Servicing Lender Name Community Bank, National Association
Servicing Lender Address 45-49 Court St, CANTON, NY, 13617-1118
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address GOWANDA, CATTARAUGUS, NY, 14070-0001
Project Congressional District NY-23
Number of Employees 22
NAICS code 814110
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 47029
Originating Lender Name Community Bank, National Association
Originating Lender Address CANTON, NY
Gender Male Owned
Veteran Unanswered
Forgiveness Amount 206273.7
Forgiveness Paid Date 2021-06-02

Related by officers

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Date of last update: 16 Mar 2025

Sources: New York Secretary of State

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