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HEALTH SYSTEM PHYSICIAN, P.C.

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Company Details

Name: HEALTH SYSTEM PHYSICIAN, P.C.
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE CORPORATION
Status: Active
Date of registration: 12 May 2011 (14 years ago)
Entity Number: 4093849
ZIP code: 14760
County: Cattaraugus
Place of Formation: New York
Address: 515 MAIN STREET, OLEAN, NY, United States, 14760
Principal Address: 130 SOUTH UNION ST, OLEAN, NY, United States, 14760

Contact Details

Phone +1 716-945-3000

Phone +1 716-379-8113

Phone +1 716-373-1590

Phone +1 716-806-1535

Phone +1 716-981-1010

Phone +1 585-968-0686

Shares Details

Shares issued 100

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
WILLIAM FOWLER MILLS, MD Chief Executive Officer 130 SOUTH UNION ST, OLEAN, NY, United States, 14760

DOS Process Agent

Name Role Address
HEALTH SYSTEM PHYSICIAN, P.C. DOS Process Agent 515 MAIN STREET, OLEAN, NY, United States, 14760

National Provider Identifier

NPI Number:
1649600081
Certification Date:
2022-05-20

Authorized Person:

Name:
JILL M OWENS
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
No
Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
8339532016
Fax:
7163798115

Form 5500 Series

Employer Identification Number (EIN):
464304317
Plan Year:
2023
Number Of Participants:
7
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
23
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
23
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
27
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
21
Sponsors Telephone Number:

History

Start date End date Type Value
2019-07-18 2021-05-03 Address 515 MAIN STREET, OLEAN, NY, 14760, USA (Type of address: Service of Process)
2014-04-15 2019-07-18 Address ATTN: PRESIDENT, 130 SOUTH UNION ST, OLEAN, NY, 14760, USA (Type of address: Service of Process)
2011-05-12 2024-01-30 Shares Share type: NO PAR VALUE, Number of shares: 100, Par value: 0
2011-05-12 2014-04-15 Address ATTN: PRESIDENT, 130 SOUTH UNION STREET, OLEAN, NY, 14760, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
210503060894 2021-05-03 BIENNIAL STATEMENT 2021-05-01
190718000556 2019-07-18 CERTIFICATE OF CHANGE 2019-07-18
140821000444 2014-08-21 CERTIFICATE OF AMENDMENT 2014-08-21
140415002291 2014-04-15 BIENNIAL STATEMENT 2013-05-01
110512001025 2011-05-12 CERTIFICATE OF INCORPORATION 2011-05-12

Tax Exempt

Employer Identification Number (EIN) :
46-4304317
Classification:
Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Ruling Date:
2015-04
National Taxonomy Of Exempt Entities:
Health Care: Hospitals and Related Primary Medical Care Facilities
Deductibility:
Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Determination Letters

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Date of last update: 27 Mar 2025

Sources: New York Secretary of State