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Rural Health Medical Program, Inc.

Details

Name: Rural Health Medical Program, Inc.
Jurisdiction: Alabama
Legal type: Domestic Non-Profit Corporation
Status: Exists
Date of registration: 31 Jul 1978 (46 years ago) (Companies founded in July 1978)
Entity Number: 000-817-519
Register Number: 000817519
ZIP code: 36701 (Companies in Dallas, 36701)
County: Dallas
Place of Formation: Dallas County
Principal Address: SELMA, AL
Registered Office Street Address: 1107 VOEGLIN AVESELMA, AL 36701

Activities HEALTH SERVICES/CHARITABLE/SCIENTIFIC/EDUCATIONAL PURPOSES

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
UFR2G6C5LXP7 2024-12-26 101 PARK PL, SELMA, AL, 36701, 6764, USA 101 PARK PL, SELMA, AL, 36701, 6764, USA

Business Information

Doing Business As UNIONTOWN HEALTH SERVICES
URL http://www.rhmpi.com/
Congressional District 07
State/Country of Incorporation AL, USA
Activation Date 2024-01-10
Initial Registration Date 2003-11-12
Entity Start Date 1977-10-01
Fiscal Year End Close Date Jun 30

Service Classifications

NAICS Codes 621112, 621210, 621320, 621330, 621391, 621498, 621999

Points of Contacts

Electronic Business
Title PRIMARY POC
Name KESHEE D DOZIER-SMITH
Role CEO
Address 101 PARK PLACE, PO BOX 2213, SELMA, AL, 36701, USA
Title ALTERNATE POC
Name MENEKA N JOHNSON
Role CORPORATE COMPLIANCE OFFICER
Address 101 PARK PLACE, SELMA, AL, 36701, USA
Government Business
Title PRIMARY POC
Name KESHEE DOZIER-SMITH
Role CEO
Address 101 PARK PLACE, PO BOX 2213, SELMA, AL, 36701, USA
Title ALTERNATE POC
Name LATOYA FREEMAN
Role HR DIRECTOR
Address 101 PARK PLACE, SELMA, AL, 36701, USA
Past Performance
Title PRIMARY POC
Name TREVOR TAYLOR
Role CONTROLLER
Address 101 PARK PLACE, PO BOX 2213, SELMA, AL, 36701, USA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1750164315 2023-08-17 2023-08-17 PO BOX 2213, SELMA, AL, 367022213, US 101 PARK PL, SELMA, AL, 367016764, US

Contacts

Phone +1 334-874-7428
Fax 3348747435
Fax 3348747428

Authorized person

Name KESHEE DANEE SMITH
Role CEO
Phone 3348747428

Taxonomy

Taxonomy Code 101YM0800X - Mental Health Counselor
Is Primary No
Taxonomy Code 122300000X - Dentist
Is Primary No
Taxonomy Code 152W00000X - Optometrist
Is Primary No
Taxonomy Code 207Q00000X - Family Medicine Physician
Is Primary Yes

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
3LNQ7 Active Non-Manufacturer 2003-11-12 2024-01-10 2029-01-10 2024-12-26

Contact Information

POC KESHEE DOZIER-SMITH
Phone +1 334-874-7428
Fax +1 334-874-7435
Address 101 PARK PL, SELMA, DALLAS, AL, 36701 6764, 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
RURAL HEALTH MEDICAL PROGRAM, INC.401(K) PLAN 2023 630737968 2024-10-04 RURAL HEALTH MEDICAL PROGRAM, INC. 71
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621112
Sponsor’s telephone number 3348747428
Plan sponsor’s address 101 PARK PLACE, SELMA, AL, 36701
RURAL HEALTH MEDICAL PROGRAM, INC.401(K) PLAN 2022 630737968 2023-09-19 RURAL HEALTH MEDICAL PROGRAM, INC. 71
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621112
Sponsor’s telephone number 3348747428
Plan sponsor’s address 101 PARK PLACE, SELMA, AL, 36701
RURAL HEALTH MEDICAL PROGRAM, INC.401(K) PLAN 2021 630737968 2022-09-30 RURAL HEALTH MEDICAL PROGRAM, INC. 63
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621112
Sponsor’s telephone number 3348747428
Plan sponsor’s address 101 PARK PLACE, SELMA, AL, 36701
RURAL HEALTH MEDICAL PROGRAM INC 2020 630737968 2021-10-04 RURAL HEALTH MEDICAL PROGRAM INC 68
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621112
Sponsor’s telephone number 3348747428
Plan sponsor’s address 101 PARK PLACE, SELMA, AL, 36701

Signature of

Role Plan administrator
Date 2021-10-04
Name of individual signing LATOYA FREEMAN
RURAL HEALTH MEDICAL PROGRAM, INC.401(K) PLAN 2020 630737968 2021-10-14 RURAL HEALTH MEDICAL PROGRAM, INC. 66
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621112
Sponsor’s telephone number 3348747428
Plan sponsor’s address 101 PARK PLACE, SELMA, AL, 36701
RURAL HEALTH MEDICAL PROGRAM INC 2019 630737968 2020-07-23 RURAL HEALTH MEDICAL PROGRAM INC 54
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2019-01-01
Business code 621112
Sponsor’s telephone number 3348747428
Plan sponsor’s address 101 PARK PLACE, SELMA, AL, 36701

Signature of

Role Plan administrator
Date 2020-07-23
Name of individual signing LATOYA FREEMAN
RURAL HEALTH MEDICAL PROGRAM INC 2018 630737968 2020-11-24 RURAL HEALTH MEDICAL PROGRAM INC 32
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 621112
Sponsor’s telephone number 3348747428
Plan sponsor’s address 101 PARK PL, SELMA, AL, 367016764

Signature of

Role Plan administrator
Date 2020-11-24
Name of individual signing LATOYA FREEMAN

Agent

Name Role
CREAR, JOHN Agent

Incorporator

Name Role
CREAR, JOHN Incorporator
MERRITT, EVELYN Incorporator
WEAVER, MARY Incorporator

Date of last update: 16 Aug 2024

Sources: Alabama Secretary of State