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CHURCHVILLE-CHILI FAMILY MEDICINE, LLC

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Company Details

Name: CHURCHVILLE-CHILI FAMILY MEDICINE, LLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 12 Oct 2007 (18 years ago)
Entity Number: 3579295
ZIP code: 14514
County: Monroe
Place of Formation: New York
Address: 4201 BUFFALO RD, PO BOX 505, NORTH CHILI, NY, United States, 14514

Agent

Name Role Address
HENRY PASZKO, M.D. Agent 4201 BUFFALO ROAD, NORTH CHILI, NY, 14514

DOS Process Agent

Name Role Address
(DELETE THE HYPHEN) CHURCHVILLE CHILI FAMILY MEDICINE, LLC DOS Process Agent 4201 BUFFALO RD, PO BOX 505, NORTH CHILI, NY, United States, 14514

National Provider Identifier

NPI Number:
1326231291

Authorized Person:

Name:
DR. HENRY MIKOLAJ PASZKO
Role:
MEDICAL DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
261Q00000X - Clinic/Center
Is Primary:
No
Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
5855945425

Form 5500 Series

Employer Identification Number (EIN):
464927775
Plan Year:
2023
Number Of Participants:
31
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
27
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
23
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
20
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
19
Sponsors Telephone Number:

History

Start date End date Type Value
2013-10-17 2023-10-02 Address 4201 BUFFALO RD, PO BOX 505, NORTH CHILI, NY, 14514, USA (Type of address: Service of Process)
2009-10-21 2013-10-17 Address 4201 BUFFALO RD, PO BOX 505, NORTH CHILI, NY, 14514, USA (Type of address: Service of Process)
2007-10-12 2023-10-02 Address 4201 BUFFALO ROAD, NORTH CHILI, NY, 14514, USA (Type of address: Registered Agent)
2007-10-12 2009-10-21 Address 4201 BUFFALO ROAD, NORTH CHILI, NY, 14514, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
231002000609 2023-10-02 BIENNIAL STATEMENT 2023-10-01
211020001082 2021-10-20 BIENNIAL STATEMENT 2021-10-20
191003060243 2019-10-03 BIENNIAL STATEMENT 2019-10-01
171010006047 2017-10-10 BIENNIAL STATEMENT 2017-10-01
151016006215 2015-10-16 BIENNIAL STATEMENT 2015-10-01

USAspending Awards / Financial Assistance

Date:
2020-06-22
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO PROVIDE LOANS TO RESTORE AS NEARLY AS POSSIBLE THE VICTIMS OF ECONOMIC INJURY TYPE DISASTERS TO PRE-DISASTER CONDITIONS
Obligated Amount:
0.00
Face Value Of Loan:
10100.00
Total Face Value Of Loan:
10100.00
Date:
2020-06-01
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
10000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-04-08
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
297200.00
Total Face Value Of Loan:
297200.00

Paycheck Protection Program

Date Approved:
2020-04-07
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
297200
Current Approval Amount:
297200
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
299047.81

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Date of last update: 28 Mar 2025

Sources: New York Secretary of State