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PORT CITY FAMILY MEDICINE, P.C.

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Company Details

Name: PORT CITY FAMILY MEDICINE, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 16 Jan 2002 (24 years ago)
Entity Number: 2719616
ZIP code: 13126
County: Oswego
Place of Formation: New York
Address: 56 Cavan Cove, Oswego, NY, United States, 13126
Principal Address: 33 E SCHUYLER ST, OSWEGO, NY, United States, 13126

Shares Details

Shares issued 50

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
MATTHEW J. LIEPKE Chief Executive Officer 33 E SCHUYLER ST, OSWEGO, NY, United States, 13126

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 56 Cavan Cove, Oswego, NY, United States, 13126

National Provider Identifier

NPI Number:
1215028055

Authorized Person:

Name:
DR. CORLISS ADAM VARNUM
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No
Selected Taxonomy:
208000000X - Pediatrics Physician
Is Primary:
No
Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
3153423625

Form 5500 Series

Employer Identification Number (EIN):
100008246
Plan Year:
2024
Number Of Participants:
14
Sponsors Telephone Number:
Plan Year:
2023
Number Of Participants:
15
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
14
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
16
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
13
Sponsors Telephone Number:

History

Start date End date Type Value
2024-01-02 2024-01-02 Address 33 E SCHUYLER ST, OSWEGO, NY, 13126, USA (Type of address: Chief Executive Officer)
2006-02-01 2024-01-02 Address 33E SCHUYLER ST, OSWEGO, NY, 13126, USA (Type of address: Service of Process)
2006-02-01 2024-01-02 Address 33 E SCHUYLER ST, OSWEGO, NY, 13126, USA (Type of address: Chief Executive Officer)
2004-01-08 2006-02-01 Address 209 W SEVENTH ST, OSWEGO, NY, 13126, USA (Type of address: Principal Executive Office)
2004-01-08 2006-02-01 Address 209 W SEVENTH ST, OSWEGO, NY, 13126, USA (Type of address: Chief Executive Officer)

Filings

Filing Number Date Filed Type Effective Date
240102005095 2024-01-02 BIENNIAL STATEMENT 2024-01-02
220701003502 2022-07-01 BIENNIAL STATEMENT 2022-01-01
140206002170 2014-02-06 BIENNIAL STATEMENT 2014-01-01
120130002379 2012-01-30 BIENNIAL STATEMENT 2012-01-01
100114002150 2010-01-14 BIENNIAL STATEMENT 2010-01-01

Paycheck Protection Program

Jobs Reported:
16
Initial Approval Amount:
$142,562
Date Approved:
2021-05-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$142,562
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Male Owned
Veteran:
Unanswered
Forgiveness Amount:
$143,257.23
Servicing Lender:
Pathfinder Bank
Use of Proceeds:
Payroll: $142,558
Utilities: $1

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Date of last update: 30 Mar 2025

Sources: New York Secretary of State