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HEALTHSOURCE MEDICAL SERVICES, PLLC

HEALTHSOURCE MEDICAL SERVICES, PLLC

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Company Details

Name:	HEALTHSOURCE MEDICAL SERVICES, PLLC
Jurisdiction:	New York
Legal type:	DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status:	Active
Date of registration:	19 Nov 2009 (16 years ago)
Entity Number:	3880616
ZIP code:	11733
County:	Suffolk
Place of Formation:	New York
Address:	P.O. BOX 206, E. SETAUKET, NY, United States, 11733

DOS Process Agent

Name	Role	Address
THE LLC	DOS Process Agent	P.O. BOX 206, E. SETAUKET, NY, United States, 11733

National Provider Identifier

NPI Number:

1891028650

Link:

View on NPI website

Authorized Person:

Name:

DR. JOHN FOLAN

Role:

MD

Phone:

6314350110

Taxonomy:

Selected Taxonomy:

207R00000X - Internal Medicine Physician

Is Primary:

Yes

Contacts:

Phone:

+1 631-435-0110

Form 5500 Series

Employer Identification Number (EIN):

271518224

Plan Year:

2023

Number Of Participants:

29

Sponsors Telephone Number:

6314350110

File:

Plan Year:

2022

Number Of Participants:

30

Sponsors Telephone Number:

6314350110

File:

Plan Year:

2021

Number Of Participants:

30

Sponsors Telephone Number:

6314350110

File:

Plan Year:

2020

Number Of Participants:

29

Sponsors Telephone Number:

6314350110

File:

Plan Year:

2019

Number Of Participants:

29

Sponsors Telephone Number:

6314350110

File:

Filings

Filing Number	Date Filed	Type	Effective Date
140115002497	2014-01-15	BIENNIAL STATEMENT	2013-11-01
111208002743	2011-12-08	BIENNIAL STATEMENT	2011-11-01
100114000085	2010-01-14	CERTIFICATE OF AMENDMENT	2010-01-14
091119000401	2009-11-19	ARTICLES OF ORGANIZATION	2009-11-19

USAspending Awards / Financial Assistance

Date:

2021-03-13

Link:

View on USAspending

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:

189787.00

Total Face Value Of Loan:

189787.00

Date:

2020-05-02

Link:

View on USAspending

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:

163865.00

Total Face Value Of Loan:

163865.00

Paycheck Protection Program

Date Approved:

2021-03-13

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Initial Approval Amount:

189787

Current Approval Amount:

189787

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

191522.92

Date Approved:

2020-05-01

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Initial Approval Amount:

163865

Current Approval Amount:

163865

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

165457.49

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Date of last update: 27 Mar 2025

Sources: New York Secretary of State