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LAKE CITY PRIMARY CARE, PLLC

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Company Details

Name: LAKE CITY PRIMARY CARE, PLLC
Jurisdiction: New York
Legal type: DOMESTIC PROFESSIONAL SERVICE LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 20 Jul 2011 (14 years ago)
Entity Number: 4120694
ZIP code: 12901
County: Clinton
Place of Formation: New York
Address: 16 DEGRANDEPRE WAY, SUITE 300, PLATTSBURGH, NY, United States, 12901

Contact Details

Phone +1 518-561-8256

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent 16 DEGRANDEPRE WAY, SUITE 300, PLATTSBURGH, NY, United States, 12901

National Provider Identifier

NPI Number:
1164850053

Authorized Person:

Name:
MS. KELLEY BRAULT
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No
Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
452815985
Plan Year:
2023
Number Of Participants:
29
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
28
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
25
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
28
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
26
Sponsors Telephone Number:

Filings

Filing Number Date Filed Type Effective Date
131008006068 2013-10-08 BIENNIAL STATEMENT 2013-07-01
110920000876 2011-09-20 CERTIFICATE OF PUBLICATION 2011-09-20
110720000857 2011-07-20 ARTICLES OF ORGANIZATION 2011-07-20

USAspending Awards / Financial Assistance

Date:
2021-03-06
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:
262125.00
Total Face Value Of Loan:
262125.00
Date:
2021-03-01
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:
-147500.00
Total Face Value Of Loan:
0.00
Date:
2020-04-29
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:
156000.00
Total Face Value Of Loan:
156000.00

Paycheck Protection Program

Date Approved:
2021-03-06
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
262125
Current Approval Amount:
262125
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
264803.7
Date Approved:
2020-04-08
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
156000
Current Approval Amount:
156000
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
157282.37

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Date of last update: 27 Mar 2025

Sources: New York Secretary of State