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  5. DELAWARE VALLEY HOSPITAL, INC.

DELAWARE VALLEY HOSPITAL, INC.

Company Details

Name: DELAWARE VALLEY HOSPITAL, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 25 Oct 1948 (76 years ago)
Entity Number: 72398
ZIP code: 13856
County: Delaware
Place of Formation: New York
Address: 1 TITUS PLACE, WALTON, NY, United States, 13856

Contact Details

Phone +1 607-865-2781

Phone +1 607-498-4800

Phone +1 607-865-2400

Phone +1 607-363-2517

Phone +1 607-865-2100

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
VKXYMHMNU655 2024-09-19 1 TITUS PL, WALTON, NY, 13856, 1457, USA 1 TITUS PL, WALTON, NY, 13856, 1457, USA

Business Information
Doing Business As DELAWARE VALLEY HOSPITAL INC
Congressional District 19
State/Country of Incorporation NY, USA
Activation Date 2023-09-22
Initial Registration Date 2013-06-19
Entity Start Date 1948-10-04
Fiscal Year End Close Date Dec 31

Points of Contacts
Electronic Business
Title PRIMARY POC
Name LUCINDA M RIDER
Role CHIEF FINANCIAL OFFICER
Address 1 TITUS PLACE, WALTON, NY, 13856, USA
Title ALTERNATE POC
Name ROLLAND V. BOJO, JR.
Role PRESIDENT/CEO
Address 1 TITUS PLACE, WALTON, NY, 13856, USA
Government Business
Title PRIMARY POC
Name LUCINDA M RIDER
Role CHIEF FINANCIAL OFFICER
Address 1 TITUS PLACE, WALTON, NY, 13856, USA
Title ALTERNATE POC
Name ROLLAND V. BOJO, JR.
Role PRESIDENT/CEO
Address 1 TITUS PLACE, WALTON, NY, 13856, USA
Past Performance Information not Available

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
6YTL1 Obsolete Non-Manufacturer 2013-09-04 2024-08-14 No data 2025-08-12

Contact Information
POC LUCINDA M. RIDER
Phone +1 607-865-2190
Fax +1 607-865-8990
Address 1 TITUS PL, WALTON, NY, 13856 1457, UNITED STATES

Ownership of Offeror Information
Highest Level Owner Information not Available
Immediate Level Owner Information not Available
List of Offerors (0) Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DELAWARE VALLEY HOSPITAL LIFE INSURANCE 2014 150524324 2015-10-14 DELAWARE VALLEY HOSPITAL 233
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2013-01-01
Business code 622000
Sponsor’s telephone number 6078652100
Plan sponsor’s mailing address 1 TITUS PLACE, WALTON, NY, 13856
Plan sponsor’s address 1 TITUS PLACE, WALTON, NY, 13856

Number of participants as of the end of the plan year
Active participants 122
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0

Signature of
Role Plan administrator
Date 2015-10-14
Name of individual signing MICHAEL MCNALLY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-14
Name of individual signing BRIAN KELLER
Valid signature Filed with authorized/valid electronic signature
DELAWARE VALLEY HOSPITAL - DENTAL, VISION AND LIFE INSURANCE 2013 150524324 2014-07-23 DELAWARE VALLEY HOSPITAL 233
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2013-01-01
Business code 622000
Sponsor’s telephone number 6078652100
Plan sponsor’s mailing address 1 TITUS PLACE, WALTON, NY, 13856
Plan sponsor’s address 1 TITUS PLACE, WALTON, NY, 13856

Number of participants as of the end of the plan year
Active participants 233

Signature of
Role Plan administrator
Date 2014-07-22
Name of individual signing LUCINDA RIDER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-07-22
Name of individual signing LUCINDA RIDER
Valid signature Filed with authorized/valid electronic signature
DELAWARE VALLEY HOSPITAL - MEDICAL, DENTAL, VISION AND LIFE INSURANCE 2012 150524324 2013-10-09 DELAWARE VALLEY HOSPITAL, INC. 289
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2012-01-01
Business code 622000
Sponsor’s telephone number 6078652190
Plan sponsor’s mailing address 1 TITUS PLACE, WALTON, NY, 13856
Plan sponsor’s address 1 TITUS PLACE, WALTON, NY, 13856

Number of participants as of the end of the plan year
Active participants 289

Signature of
Role Plan administrator
Date 2013-10-09
Name of individual signing PAUL SUMMERS
Valid signature Filed with authorized/valid electronic signature
DELAWARE VALLEY HOSPITAL - MEDICAL, DENTAL, VISION AND LIFE INSURANCE 2011 150524324 2012-07-27 DELAWARE VALLEY HOSPITAL 281
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2011-01-01
Business code 622000
Sponsor’s telephone number 6078652100
Plan sponsor’s mailing address 1 TITUS PLACE, WALTON, NY, 13856
Plan sponsor’s address 1 TITUS PLACE, WALTON, NY, 13856

Plan administrator’s name and address
Administrator’s EIN 150524324
Plan administrator’s name DELAWARE VALLEY HOSPITAL
Plan administrator’s address 1 TITUS PLACE, WALTON, NY, 13856
Administrator’s telephone number 6078652100

Number of participants as of the end of the plan year
Active participants 281

Signature of
Role Plan administrator
Date 2012-07-27
Name of individual signing PAUL SUMMERS
Valid signature Filed with authorized/valid electronic signature
DELAWARE VALLEY HOSPITAL - MEDICAL, DENTAL, VISION & LIFE INSURANCE 2010 150524324 2011-10-06 DELAWARE VALLEY HOSPITAL 285
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2010-01-01
Business code 622000
Sponsor’s telephone number 6078652100
Plan sponsor’s mailing address 1 TITUS PLACE, WALTON, NY, 13856
Plan sponsor’s address 1 TITUS PLACE, WALTON, NY, 13856

Plan administrator’s name and address
Administrator’s EIN 150524324
Plan administrator’s name DELAWARE VALLEY HOSPITAL
Plan administrator’s address 1 TITUS PLACE, WALTON, NY, 13856
Administrator’s telephone number 6078652100

Number of participants as of the end of the plan year
Active participants 285

Signature of
Role Plan administrator
Date 2011-08-24
Name of individual signing PAUL SUMMERS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-10-06
Name of individual signing DAVID POLGE
Valid signature Filed with authorized/valid electronic signature
DELAWARE VALLEY HOSPITAL - MEDICAL, DENTAL, VISION AND LIFE INSURANCE 2009 150524324 2010-10-13 DELAWARE VALLEY HOSPITAL, INC. 279
File View Page
Three-digit plan number (PN) 502
Effective date of plan 2009-01-01
Business code 622000
Sponsor’s telephone number 6078652190
Plan sponsor’s mailing address 1 TITUS PLACE, WALTON, NY, 13856
Plan sponsor’s address 1 TITUS PLACE, WALTON, NY, 13856

Plan administrator’s name and address
Administrator’s EIN 150524324
Plan administrator’s name DELAWARE VALLEY HOSPITAL, INC.
Plan administrator’s address 1 TITUS PLACE, WALTON, NY, 13856
Administrator’s telephone number 6078652190

Number of participants as of the end of the plan year
Active participants 279

Signature of
Role Plan administrator
Date 2010-10-13
Name of individual signing DAVID POLGE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-13
Name of individual signing PAUL SUMMERS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
DELAWARE VALLEY HOSPITAL, INC. Agent 1 TITUS PLACE, WALTON, NY

DOS Process Agent

Name Role Address
%DELAWARE VALLEY HOSP., INC. DOS Process Agent 1 TITUS PLACE, WALTON, NY, United States, 13856

Filings

Filing Number Date Filed Type Effective Date
B067900-2 1984-02-09 ASSUMED NAME CORP INITIAL FILING 1984-02-09
A928867-11 1982-12-13 CERTIFICATE OF AMENDMENT 1982-12-13
A102804-2 1973-09-21 CERTIFICATE OF AMENDMENT 1973-09-21
565Q-135 1952-12-08 CERTIFICATE OF AMENDMENT 1952-12-08
536Q-137 1950-11-21 CERTIFICATE OF AMENDMENT 1950-11-21
524Q-101 1950-01-24 CERTIFICATE OF AMENDMENT 1950-01-24
506Q-16 1948-10-25 CERTIFICATE OF INCORPORATION 1948-10-25

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
15-0524324 Corporation Unconditional Exemption 1 TITUS PL, WALTON, NY, 13856-1457 1953-04
In Care of Name % FINANCE DEPARTMENT
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
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)
Deductibility Contributions are deductible.
Foundation Hospital or medical research organization 170(b)(1)(A)(iii)
Tax Period 2023-12
Asset 10,000,000 to 49,999,999
Income 10,000,000 to 49,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Dec
Asset Amount 46572124
Income Amount 43056565
Form 990 Revenue Amount 43056565
National Taxonomy of Exempt Entities -
Sort Name -

Publication 78 Data
Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name DELAWARE VALLEY HOSPITAL INC
EIN 15-0524324
Tax Period 202212
Filing Type E
Return Type 990
File View File
Organization Name DELAWARE VALLEY HOSPITAL INC
EIN 15-0524324
Tax Period 202112
Filing Type E
Return Type 990
File View File
Organization Name DELAWARE VALLEY HOSPITAL INC
EIN 15-0524324
Tax Period 202012
Filing Type E
Return Type 990
File View File
Organization Name DELAWARE VALLEY HOSPITAL INC
EIN 15-0524324
Tax Period 201912
Filing Type E
Return Type 990
File View File
Organization Name DELAWARE VALLEY HOSPITAL INC
EIN 15-0524324
Tax Period 201812
Filing Type E
Return Type 990
File View File
Organization Name DELAWARE VALLEY HOSPITAL INC
EIN 15-0524324
Tax Period 201712
Filing Type E
Return Type 990
File View File
Organization Name DELAWARE VALLEY HOSPITAL INC
EIN 15-0524324
Tax Period 201612
Filing Type E
Return Type 990
File View File
Organization Name DELAWARE VALLEY HOSPITAL INC
EIN 15-0524324
Tax Period 201512
Filing Type E
Return Type 990
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
8034367002 2020-04-08 0248 PPP 1 Titus Place, WALTON, NY, 13856-1457
Loan Status Date 2021-05-06
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 1933997
Loan Approval Amount (current) 1933997
Undisbursed Amount 0
Franchise Name -
Lender Location ID 60383
Servicing Lender Name Wayne Bank
Servicing Lender Address 717 Main St, HONESDALE, PA, 18431-1844
Rural or Urban Indicator R
Hubzone Y
LMI N
Business Age Description Existing or more than 2 years old
Project Address WALTON, DELAWARE, NY, 13856-1457
Project Congressional District NY-19
Number of Employees 150
NAICS code 622110
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 60383
Originating Lender Name Wayne Bank
Originating Lender Address HONESDALE, PA
Gender Female Owned
Veteran Unanswered
Forgiveness Amount 1953981.64
Forgiveness Paid Date 2021-04-23

Related by officers

No related officers

Related by address

1 TITUS PLACE, WALTON, NY, United States, 13856

CHARLES W. JONES, M.D., P.C.

Date of last update: 02 Mar 2025

Sources: New York Secretary of State

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