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SLOCUM DICKSON MEDICAL GROUP, PLLC

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Company Details

Name: SLOCUM DICKSON MEDICAL GROUP, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 02 Jul 2002 (23 years ago)
Entity Number: 2785389
ZIP code: 13413
County: Oneida
Place of Formation: New York
Address: 1729 BURRSTONE ROAD, NEW HARTFORD, NY, United States, 13413

Contact Details

Phone +1 315-798-4500

Phone +1 315-798-1500

DOS Process Agent

Name Role Address
SLOCUM DICKSON MEDICAL GROUP, PLLC DOS Process Agent 1729 BURRSTONE ROAD, NEW HARTFORD, NY, United States, 13413

National Provider Identifier

NPI Number:
1285625996
Certification Date:
2021-06-11

Authorized Person:

Name:
DR. STEPHEN D. EADLINE
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
291U00000X - Clinical Medical Laboratory
Is Primary:
No
Selected Taxonomy:
261Q00000X - Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
3157981707

Legal Entity Identifier

LEI Number:
549300CIB78CO3F9LL42

Registration Details:

Initial Registration Date:
2018-03-01
Next Renewal Date:
2020-02-29
Registration Status:
LAPSED
Validation Source:
FULLY_CORROBORATED

Form 5500 Series

Employer Identification Number (EIN):
200362623
Plan Year:
2023
Number Of Participants:
387
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
314
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
329
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
326
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
316
Sponsors Telephone Number:

History

Start date End date Type Value
2002-07-02 2024-04-04 Address 1729 BURRSTONE ROAD, NEW HARTFORD, NY, 13413, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
240404003769 2024-04-04 BIENNIAL STATEMENT 2024-04-04
200716060489 2020-07-16 BIENNIAL STATEMENT 2020-07-01
180711006049 2018-07-11 BIENNIAL STATEMENT 2018-07-01
160727006029 2016-07-27 BIENNIAL STATEMENT 2016-07-01
120705006145 2012-07-05 BIENNIAL STATEMENT 2012-07-01

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Date of last update: 30 Mar 2025

Sources: New York Secretary of State