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  5. SOUTHERN TIER PULMONARY & CRITICAL CARE MEDICINE, LLC

SOUTHERN TIER PULMONARY & CRITICAL CARE MEDICINE, LLC

Company Details

Name: SOUTHERN TIER PULMONARY & CRITICAL CARE MEDICINE, LLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 17 May 2006 (19 years ago)
Entity Number: 3363364
ZIP code: 13790
County: Broome
Place of Formation: New York
Address: 52 HARRISON STREET / SUITE 1, JOHNSON CITY, NY, United States, 13790

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTHERN TIER PULMONARY 401(K) RETIREMENT PLAN 2023 205020595 2024-07-18 SOUTHERN TIER PULMONARY & CRITICAL CARE MEDICINE, LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 621111
Sponsor’s telephone number 6077298845
Plan sponsor’s address 52 HARRISON STREET, SUITE 1, JOHNSON CITY, NY, 137902120

Signature of
Role Plan administrator
Date 2024-07-18
Name of individual signing MUHAMMAD ALI
Role Employer/plan sponsor
Date 2024-07-18
Name of individual signing MUHAMMAD ALI
SOUTHERN TIER PULMONARY CASH BALANCE PLAN 2023 205020595 2024-07-11 SOUTHERN TIER PULMONARY & CRITICAL CARE MEDICINE, LLC 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 6077298845
Plan sponsor’s address 52 HARRISON STREET, SUITE 1, JOHNSON CITY, NY, 137902120

Signature of
Role Plan administrator
Date 2024-07-10
Name of individual signing MUHAMMAD ALI
Role Employer/plan sponsor
Date 2024-07-10
Name of individual signing MUHAMMAD ALI
SOUTHERN TIER PULMONARY CASH BALANCE PLAN 2022 205020595 2023-05-23 SOUTHERN TIER PULMONARY & CRITICAL CARE MEDICINE, LLC 12
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 6077298845
Plan sponsor’s address 52 HARRISON STREET, SUITE 1, JOHNSON CITY, NY, 137902120

Signature of
Role Plan administrator
Date 2023-05-23
Name of individual signing MUHAMMAD ALI
Role Employer/plan sponsor
Date 2023-05-23
Name of individual signing MUHAMMAD ALI
SOUTHERN TIER PULMONARY 401(K) RETIREMENT PLAN 2022 205020595 2023-06-29 SOUTHERN TIER PULMONARY & CRITICAL CARE MEDICINE, LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 621111
Sponsor’s telephone number 6077298845
Plan sponsor’s address 52 HARRISON STREET, SUITE 1, JOHNSON CITY, NY, 137902120

Signature of
Role Plan administrator
Date 2023-06-28
Name of individual signing MUHAMMAD ALI
Role Employer/plan sponsor
Date 2023-06-28
Name of individual signing MUHAMMAD ALI
SOUTHERN TIER PULMONARY CASH BALANCE PLAN 2021 205020595 2022-07-13 SOUTHERN TIER PULMONARY & CRITICAL CARE MEDICINE, LLC 12
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 6077298845
Plan sponsor’s address 52 HARRISON STREET, SUITE 1, JOHNSON CITY, NY, 137902120

Signature of
Role Plan administrator
Date 2022-07-12
Name of individual signing SHANNON HUFF
Role Employer/plan sponsor
Date 2022-07-12
Name of individual signing SHANNON HUFF
SOUTHERN TIER PULMONARY 401(K) RETIREMENT PLAN 2021 205020595 2022-07-14 SOUTHERN TIER PULMONARY & CRITICAL CARE MEDICINE, LLC 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 621111
Sponsor’s telephone number 6077298845
Plan sponsor’s address 52 HARRISON STREET, SUITE 1, JOHNSON CITY, NY, 137902120

Signature of
Role Plan administrator
Date 2022-07-13
Name of individual signing MUHAMMAD ALI
Role Employer/plan sponsor
Date 2022-07-13
Name of individual signing MUHAMMAD ALI
SOUTHERN TIER PULMONARY CASH BALANCE PLAN 2020 205020595 2021-09-24 SOUTHERN TIER PULMONARY & CRITICAL CARE MEDICINE, LLC 11
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 6077298845
Plan sponsor’s address 52 HARRISON STREET, SUITE 1, JOHNSON CITY, NY, 137902120

Signature of
Role Plan administrator
Date 2021-09-22
Name of individual signing MUHAMMAD ALI
Role Employer/plan sponsor
Date 2021-09-22
Name of individual signing MUHAMMAD ALI
SOUTHERN TIER PULMONARY 401(K) RETIREMENT PLAN 2020 205020595 2021-05-28 SOUTHERN TIER PULMONARY & CRITICAL CARE MEDICINE, LLC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 621111
Sponsor’s telephone number 6077298845
Plan sponsor’s address 52 HARRISON STREET, SUITE 1, JOHNSON CITY, NY, 137902120

Signature of
Role Plan administrator
Date 2021-05-26
Name of individual signing MUHAMMAD IMRAN ALI
Role Employer/plan sponsor
Date 2021-05-26
Name of individual signing MUHAMMAD IMRAN ALI
SOUTHERN TIER PULMONARY CASH BALANCE PLAN 2019 205020595 2020-05-21 SOUTHERN TIER PULMONARY & CRITICAL CARE MEDICINE, LLC 9
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2018-01-01
Business code 621111
Sponsor’s telephone number 6077298845
Plan sponsor’s address 52 HARRISON STREET, SUITE 1, JOHNSON CITY, NY, 137902120

Signature of
Role Plan administrator
Date 2020-05-21
Name of individual signing MUHAMMAD IMRAN ALI
Role Employer/plan sponsor
Date 2020-05-21
Name of individual signing MUHAMMAD IMRAN ALI
SOUTHERN TIER PULMONARY 401(K) RETIREMENT PLAN 2019 205020595 2020-06-25 SOUTHERN TIER PULMONARY & CRITICAL CARE MEDICINE, LLC 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-10-01
Business code 621111
Sponsor’s telephone number 6077298845
Plan sponsor’s address 52 HARRISON STREET, SUITE 1, JOHNSON CITY, NY, 137902120

Signature of
Role Plan administrator
Date 2020-06-23
Name of individual signing SHANNON HUFF
Role Employer/plan sponsor
Date 2020-06-23
Name of individual signing SHANNON HUFF

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 52 HARRISON STREET / SUITE 1, JOHNSON CITY, NY, United States, 13790

History

Start date End date Type Value
2006-05-17 2010-06-18 Address 450 PLAZA DRIVE, VESTAL, NY, 13850, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
200512060243 2020-05-12 BIENNIAL STATEMENT 2020-05-01
180507006133 2018-05-07 BIENNIAL STATEMENT 2018-05-01
160519006234 2016-05-19 BIENNIAL STATEMENT 2016-05-01
140520006050 2014-05-20 BIENNIAL STATEMENT 2014-05-01
120625002614 2012-06-25 BIENNIAL STATEMENT 2012-05-01
100618003031 2010-06-18 BIENNIAL STATEMENT 2010-05-01
080512002173 2008-05-12 BIENNIAL STATEMENT 2008-05-01
060517000178 2006-05-17 ARTICLES OF ORGANIZATION 2006-05-17

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3501037103 2020-04-11 0248 PPP 52 Harrison St, JOHNSON CITY, NY, 13790-2120
Loan Status Date 2021-08-21
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 133613
Loan Approval Amount (current) 133613
Undisbursed Amount 0
Franchise Name -
Lender Location ID 56102
Servicing Lender Name KeyBank National Association
Servicing Lender Address 127 Public Sq, CLEVELAND, OH, 44114-1217
Rural or Urban Indicator U
Hubzone Y
LMI Y
Business Age Description Unanswered
Project Address JOHNSON CITY, BROOME, NY, 13790-2120
Project Congressional District NY-19
Number of Employees 12
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 56102
Originating Lender Name KeyBank National Association
Originating Lender Address CLEVELAND, OH
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 135296.89
Forgiveness Paid Date 2021-07-29

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Related by address

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Date of last update: 28 Mar 2025

Sources: New York Secretary of State

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