ANDERSON PHYSICIAN ALLIANCE INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- ANDERSON PHYSICIAN ALLIANCE INC (EIN 27-3274203)
- Tax period
- 2016-10-01 to 2017-09-30
- Filed
- 2018-08-14
- IRS object ID
- 201832269349300643
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-08-14T09:21:06-05:00 | ReturnTs |
| Tax Period End | 2017-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 560747981 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIXON HUGHES GOODMAN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 RIDGEFIELD COURT | AddressLine1Txt |
| City | ASHEVILLE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28806 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 273274203 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANDERSON PHYSICIAN ALLIANCE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ANDE | BusinessNameControlTxt |
| Phone | 6015536000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2124 14TH STREET | AddressLine1Txt |
| City | MERIDIAN | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39301 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | signing officer | PersonNm |
| Person Title | VP OF FINANCE | PersonTitleTxt |
| Phone | 6015536000 | PhoneNum |
| Signature | 2018-08-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Amy Bibby | PreparerPersonNm |
| PTIN | P00445891 | PTIN |
| Phone | 8282542254 | PhoneNum |
| Preparation | 2018-08-10 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEVEN BROWN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2124 14TH STREET | AddressLine1Txt |
| City | MERIDIAN | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,503,113 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ANDERSONREGIONAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2010 | FormationYr |
| Legal Domicile State | MS | LegalDomicileStateCd |
| Activity Or Mission | ANDERSON PHYSICIAN ALLIANCE, INC. OFFERS FAMILY PRACTICE AND SPECIALTY CLINICS TO PROVIDE QUALITY HEALTHCARE FOR EAST MISSISSIPPI AND WEST ALABAMA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 4 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 47 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,918,765 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,441,529 | CYProgramServiceRevenueAmt |
| PY Investment Income | $18 | PYInvestmentIncomeAmt |
| CY Investment Income | $20 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $61,564 | CYOtherRevenueAmt |
| PY Total Revenue | $3,918,783 | PYTotalRevenueAmt |
| CY Total Revenue | $4,503,113 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,748,365 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,816,154 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,962,991 | PYOtherExpensesAmt |
| CY Other Expenses | $3,227,516 | CYOtherExpensesAmt |
| PY Total Expenses | $5,711,356 | PYTotalExpensesAmt |
| CY Total Expenses | $7,043,670 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,792,573 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,540,557 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $750,553 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,210,835 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $21,878,496 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $24,963,631 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$21,127,943 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$23,752,796 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O:ANDERSON PHYSICIAN ALLIANCE, INC. IS ORGANIZED EXCLUSIVELY FOR CHARITABLE, EDUCATIONAL, AND SCIENTIFIC PURPOSES. THE SPECIFIC PURPOSES AND OBJECTIVES OF THE CORPORATION SHALL INCLUDE BUT NOT BE LIMITED TO EMPLOYING PHYSICIANS AND OTHER MEDICAL PERSONNEL TO CARRY OUT THE PURPOSES AND OBJECTIVES OF ANDERSON REGIONAL MEDICAL CENTER, AS FOLLOWS:1.) TO ESTABLISH AND MAINTAIN AN INSTITUTION OR INSTITUTIONS, WITHIN OR WITHOUT THE STATE WHERE INCORPORATED, WITH PERMANENT FACILITIES TO PROVIDE DIAGNOSIS AND TREATMENT FOR PATIENTS2.) TO CARRY ON ANY EDUCATION ACTIVITIES RELATED TO RENDERING CARE TO THE SICK AND INJURED, OR TO THE PROMOTION OF HEALTH3.) TO PROMOTE AND CARRY ON SCIENTIFIC RESEARCH RELATED TO THE CARE OF THE SICK AND INJURED4.) TO PARTICIPATE IN ANY ACTIVITY DESIGNED AND CARRIED ON TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $6,492,894 | ExpenseAmt |
| Revenue | $4,603,093 | RevenueAmt |
| Desc | SEE SCHEDULE O:Anderson Physician Alliance, Inc. offers family practice and specialty clinics to provide quality healthcare for East Mississippi and West Alabama. The physicians, nurse practitioners and staff focus on primary healthcare needs of the community.Anderson Physician Alliance, Inc. primary care clinics:- Anderson Family Medical Center - Livingston (Livingston, AL) Anderson Physician Alliance, Inc. specialty clinics:- Anderson Ear Nose & Throat Clinic focuses on the adult and pediatric diagnosis and treatment of ENT related illness.- Anderson Urology Center of Meridian provides urologic care specializing in overactive bladder, kidney stones, and urinary tract infections. Surgical treatments include: minimally invasive prostatectomy surgery using the DaVinci surgical robot.- Anderson Premier Women's Clinic provides quality care to women in Meridian and the surrounding communities. The dedicated Physician's and staff take pride in providing a genuine concerned environment for women from adolescence, to child bearing years and through maternity.Effective May 2015, Anderson Arthritis and Rheumatology, Anderson Infectious Disease Center, and Anderson Endocrinology Center ceased operations as Anderson Physician Alliance, Inc. clinics. | Desc |
| Total Program Service Expenses | $6,492,894 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 47 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 4 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STEVEN BROWN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6015536647 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2124 14TH STREET | AddressLine1Txt |
| City | MERIDIAN | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| GEORGE DENTON FARR | |||||||||
| DIRECTOR (CHAIRMAN) | 1.00 | 48.00 | Yes (X) | Yes (X) | $0 | $154,181 | $1,950 | ||
| WANDA COOPER | |||||||||
| DIRECTOR (SECRETARY) | 1.00 | 51.00 | Yes (X) | Yes (X) | $0 | $196,187 | $8,000 | ||
| SHAWN ANDERSON | |||||||||
| DIRECTOR | 1.00 | 6.00 | Yes (X) | $0 | $24,182 | $0 | |||
| STEVEN BROWN | |||||||||
| DIRECTOR | 1.00 | 50.00 | Yes (X) | $0 | $155,744 | $15,520 | |||
| MARK T PHILIPS | |||||||||
| PHYSICIAN | 40.00 | $579,148 | $0 | $2,002 | Yes (X) | ||||
| CODY AULL | |||||||||
| PHYSICIAN | 40.00 | $683,511 | $0 | $435 | Yes (X) | ||||
| ROBERT DILLWORTH | |||||||||
| PHYSICIAN | 40.00 | $316,208 | $0 | $2,472 | Yes (X) | ||||
| SILVIA BEVILACQUA | |||||||||
| PHYSICIAN | 40.00 | $475,365 | $0 | $405 | Yes (X) | ||||
| ZAINEB DAUD | |||||||||
| PHYSICIAN | 40.00 | $197,881 | $0 | $0 | Yes (X) | ||||
| JOEL WINDHAM | |||||||||
| DIRECTOR (FORMER CHAIRMAN) | 1.00 | 49.00 | $0 | $175,821 | $480 | Yes (X) | |||
| JOHN ANDERSON | |||||||||
| FORMER PRESIDENT (CEO ARMC) | 1.00 | 50.00 | $0 | $392,603 | $66,447 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,252,113 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,098,718 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $97,711 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| DELL MARKETING LP | |||||
| POB 534118 | ATLANTA | GA | 303534118 | EMR & BILLING SOFTWARE | $285,144 |
| MEDICAL ARTS SURGICAL GROUP | |||||
| 2111 14TH ST | MERIDIAN | MS | 39301 | Contract Physician Fees | $202,180 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $4,441,529 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,441,529 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,441,529 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20 | TotalRevenueColumnAmt |
| Exclusion | $20 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LIVINGSTON MOVABLE EQU | Desc |
| Business | 999999 | BusinessCd |
| Total Revenue Column | $61,564 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $61,564 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $61,564 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,503,113 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,503,093 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $20 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,566,390 | TotalAmt |
| Program Services | $3,194,111 | ProgramServicesAmt |
| Management And General | $372,279 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,034 | TotalAmt |
| Program Services | $82,089 | ProgramServicesAmt |
| Management And General | $2,945 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,730 | TotalAmt |
| Program Services | $158,884 | ProgramServicesAmt |
| Management And General | $5,846 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,700,240 | TotalAmt |
| Program Services | $1,583,528 | ProgramServicesAmt |
| Management And General | $116,712 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,881 | TotalAmt |
| Program Services | $3,881 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,034 | TotalAmt |
| Program Services | $124,673 | ProgramServicesAmt |
| Management And General | $14,361 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $450,190 | TotalAmt |
| Program Services | $446,548 | ProgramServicesAmt |
| Management And General | $3,642 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,011 | TotalAmt |
| Program Services | $2,645 | ProgramServicesAmt |
| Management And General | $1,366 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,712 | TotalAmt |
| Program Services | $2,712 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $393 | TotalAmt |
| Program Services | $393 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,781 | TotalAmt |
| Program Services | $54,581 | ProgramServicesAmt |
| Management And General | $31,200 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $142,865 | TotalAmt |
| Program Services | $142,211 | ProgramServicesAmt |
| Management And General | $654 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT EXPENSE | $398,004 | $398,004 | |
| MEDICAL SUPPLIES | $300,405 | $298,634 | $1,771 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,043,670 | TotalAmt |
| Program Services | $6,492,894 | ProgramServicesAmt |
| Management And General | $550,776 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,520 | BOYAmt |
| EOY | $1,379 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,990 | BOYAmt |
| EOY | $209,576 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $336,806 | BOYAmt |
| EOY | $605,575 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,667 | BOYAmt |
| EOY | $26,667 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,039,529 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $671,891 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $368,570 | BOYAmt |
| EOY | $367,638 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $750,553 | BOYAmt |
| EOY | $1,210,835 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $538,631 | BOYAmt |
| EOY | $575,172 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,339,865 | BOYAmt |
| EOY | $24,388,459 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,878,496 | BOYAmt |
| EOY | $24,963,631 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$21,127,943 | BOYAmt |
| EOY | -$23,752,796 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$21,127,943 | BOYAmt |
| EOY | -$23,752,796 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $750,553 | BOYAmt |
| EOY | $1,210,835 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,540,557 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$84,296 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,039,529 | OtherCostOrOtherBasisAmt |
| Depreciation | $671,891 | DepreciationAmt |
| Book Value | $367,638 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $367,638 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO AFFILIATES | Desc |
| Amt | $24,388,459 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $24,388,459 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | ANDERSON PHYSICIAN ALLIANCE IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(A) OF THE INTERNAL REVENUE CODE AS AN ORGANIZATION DESCRIBED IN SECTION 501(C)(3); ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS. ACCORDINGLY, THE ACCOMPANYING CONSOLIDATED FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION FOR INCOME TAXES. ANDERSON PHYSICIAN ALLIANCE HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2017 AND 2016. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GEORGE DENTON FARR | ||||||||||||||
| DIRECTOR (CHAIRMAN) | $0 | $153,407 | $0 | $0 | $0 | $774 | $0 | $34,570 | $0 | $0 | $0 | $188,751 | $0 | $0 |
| WANDA COOPER | ||||||||||||||
| DIRECTOR (SECRETARY) | $0 | $191,950 | $0 | $0 | $0 | $4,237 | $0 | $24,269 | $0 | $0 | $0 | $220,456 | $0 | $0 |
| STEVEN BROWN | ||||||||||||||
| DIRECTOR | $0 | $154,989 | $0 | $0 | $0 | $755 | $0 | $22,898 | $0 | $9,884 | $0 | $188,526 | $0 | $0 |
| MARK T PHILIPS | ||||||||||||||
| PHYSICIAN | $0 | $0 | $455,303 | $0 | $123,845 | $0 | $0 | $0 | $16,411 | $0 | $595,559 | $0 | $0 | $0 |
| CODY AULL | ||||||||||||||
| PHYSICIAN | $0 | $0 | $409,052 | $0 | $274,459 | $0 | $0 | $0 | $18,713 | $0 | $702,224 | $0 | $0 | $0 |
| ROBERT DILLWORTH | ||||||||||||||
| PHYSICIAN | $0 | $0 | $316,208 | $0 | $0 | $0 | $0 | $0 | $1,098 | $0 | $317,306 | $0 | $0 | $0 |
| SILVIA BEVILACQUA | ||||||||||||||
| PHYSICIAN | $0 | $0 | $270,462 | $0 | $204,903 | $0 | $0 | $0 | $19,944 | $0 | $495,309 | $0 | $0 | $0 |
| ZAINEB DAUD | ||||||||||||||
| PHYSICIAN | $0 | $0 | $197,881 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $197,881 | $0 | $0 | $0 |
| JOEL WINDHAM | ||||||||||||||
| DIRECTOR (FORMER CHAIRMAN) | $0 | $174,510 | $0 | $0 | $0 | $1,311 | $0 | $0 | $0 | $480 | $0 | $176,301 | $0 | $0 |
| JOHN ANDERSON | ||||||||||||||
| FORMER PRESIDENT (CEO ARMC) | $0 | $381,701 | $0 | $0 | $0 | $10,902 | $0 | $66,447 | $0 | $0 | $0 | $459,050 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 4b | FormAndLineReferenceDesc |
| Explanation | ARMC PROVIDES CERTAIN EXEUCTIVES AN IRC SEC 457(F), NON-QUALIFIED SUPPLEMENTAL RETIREMENT PLAN. THE FOLLOWING INDIVIDUALS PARTICIPATED IN THE 457(F) PLAN: - JOHN ANDERSON $66,447 - WANDA COOPER 34,570 - STEVEN BROWN 22,898 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section A, line 1 | UNLESS PROHIBITED OR LIMITED BY THE ARTICLES OF INCORPORATION OR THESE BYLAWS, THE BOARD OF DIRECTORS MAY CREATE AN EXECUTIVE COMMITTEE AND ONE OR MORE THAN OTHER COMMITTEES OF THE BOARD AND APPOINT MEMBERS OF THE BOARD OF DIRECTORS TO SERVE ON THEM. |
| Form 990, Part VI, Section A, line 3 | MEDICAL MANAGEMENT SERVICES IS RESPONSIBLE FOR THE DAILY MANAGEMENT OPERATIONS OF THE APA CLINICS AND APA BUSINESS OFFICE INCLUDING PERFOMRING BUDGETS AND EXPENSE APPROVAL. MEDICAL MANAGEMENT SERVICES RECOMMENDS STAFFING PERSONNAL TO THE FACILITY BUT THE FACILITY HAS THE FINAL APPROVAL FOR ALL HIRING AND FIRING OF EMPLOYEES INCLUDING PHYSICIANS. |
| Form 990, Part VI, Section A, line 6 | ANDERSON REGIONAL MEDICAL CENTER (ARMC) IS THE SOLE MEMBER OF ANDERSON PHYSICIAN ALLIANCE, INC. |
| Form 990, Part VI, Section A, line 7a | ANDERSON REGIONAL MEDICAL CENTER HAS THE POWER (1) TO APPOINT THE MEMBERS OF THE BOARD OF DIRECTORS, (2) TO EXERCICE ALL VOTING RIGHTS OF THE MEMBERS |
| Form 990, Part VI, Section A, line 7b | ANDERSON REGIONAL MEDICAL CENTER HAS THE POWER (1) TO APRROVE APA'S PHYSICIAN COMPENSATION MODELS, PHYSICIAN COMPENSATION AND PHYSICIAN COMPENSATION POLICIES, (2) TO APPROVE PHYSICIAN EMPLOYMENT AGREEMENTS, AND (3) TO INITIATE AND/OR APPROVE VARIOUS OTHER ACTIONS AND POLICIES AS ENUMERATED IN APA'S CERTIFICATE OF INCORPORATION AND BYLAWS, AND AS REQUIRED BY STATE LAW. |
| Form 990, Part VI, Section B, line 11b | EACH BOARD MEMBER WAS PROVIDED A COPY OF THE FORM 990. THE BOARD MEMBERS WERE ASKED TO REVIEW THE FORM AND SUBMIT QUESTIONS AND COMMENTS PROIR TO THE FORM 990 BEING FINALIZED. AFTER REVIEW, THE FINALIZED FORM 990 WAS PROVIDED TO THE BOARD PRIOR TO FILING. |
| Form 990, Part VI, Section B, line 12c | THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY AND REQUESTS ALL BOARD MEMBERS TO ANNUALLY DISCLOSE ANY POSSIBLE CONFLICTS OF INTEREST. |
| Form 990, Part VI, Section B, line 15 | THE BOARD OF ARMC HAS A DESIGNATED THREE (3) PERSON COMMITTEE OF INDEPENDENT BOARD MEMBERS TO REVIEW AND APPROVE COMPENSATION. THE BOARD ALSO HAD A CONTRACT FOR PROFESSIONAL SERVICES WITH MERCER UNTIL JULY 1, 2013 AND CURRENTLY USES SULLIVAN COTTER TO STUDY AND RECOMMEND COMPENSATION FOR THE CEO, THE VICE PRESIDENTS, AND THE DIRECTORS OF THE HOSPITAL. |
| Form 990, Part VI, Section C, line 18 | IN ADDITION, RECENT FILINGS OF THE FORM 990 ARE MADE AVAILABLE ONLINE AT WWW.GUIDESTAR.ORG. |
| Form 990, Part VI, Section C, line 19 | THE ORGANIZATION MAKES IT GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. |
| FORM 990, PART VI, LINE 1: INDEPENDENCE OF VOTING BOARD MEMBERS: | THE ORGANIZATION IS A SUBSIDIARY OF ANDERSON REGIONAL MEDICAL CENTER, A 501(C)(3) ORGANIZATION. THE BOARD OF DIRECTORS OF THIS ORGANIZATION FAILS TO HAVE A MAJORITY OF INDEPENDENT BOARD MEMBERS PER THE DEFINITION PROVIDED BY THE IRS. PLEASE NOTE, HOWEVER, THAT THE SOLE MEMBER ORGANIZATION HAS A FIFTY PERCENT INDEPENDENT BOARD OF DIRECTORS, AND THROUGH ITS MEMBERSHIP PROVIDES GOVERNANCE OVERSIGHT OVER THE FILING ORGANIZATION. PLEASE SEE THE RESPONSES TO FORM 990, PART VI, LINES 6 THROUGH 7B FOR DETAILS ON THE SOLE MEMBER AND ITS AUTHORITY. |
| Form 990, Part IX, line 11g | PHYSICIAN FEES: Program service expenses 1,196,324. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,196,324. PURCHASED SERVICES: Program service expenses 387,204. Management and general expenses 116,712. Fundraising expenses 0. Total expenses 503,916. |
| Form 990, Part XI, line 9: | EQUITY TRANSFER -84,296. |
| Form 990, Part XII, Line 2c: | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (6 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| ANDERSON REGIONAL MEDICAL CENTER | |||||||||||
| 2124 14TH STREET | MERIDIAN | MS | 39301 | 640362400 | HEALTHCARE | MS | 501(C)(3) | Line 3 | N/A | 0 | |
| MEDICAL SUPPORT AND DEVELOPMENT ORGANIZATION | |||||||||||
| 122 WOODMONT WAY | RIDGELAND | MS | 39157 | 640722433 | SUPPORTING ORGANIZATION | MS | 501(C)(3) | Line 12c, III-FI | 0 | ANDERSON REGIONAL MEDICAL CENTER | |
| ANDERSON SUPPORT AND DEVELOPMENT FOUNDATION | |||||||||||
| 7651 POPLAR SPRINGS DR | MERIDIAN | MS | 39305 | 640730109 | SUPPORTING ORGANIZATION | MS | 501(C)(3) | Line 12d, III-O | 0 | ANDERSON REGIONAL MEDICAL CENTER | |
| MIRACLES OF GRACE FOUNDATION | |||||||||||
| 1827 SUNRISE LANE | TOOMSUBA | MS | 39364 | 640730366 | SUPPORTING ORGANIZATION | MS | 501(C)(3) | Line 12c, III-FI | 0 | ANDERSON REGIONAL MEDICAL CENTER | |
| CARE CONSISTENCY FOUNDATION INC | |||||||||||
| 7761 MEADOW CIRCLE | MERIDIAN | MS | 39305 | 640730846 | SUPPORTING ORGANIZATION | MS | 501(C)(3) | Line 12d, III-O | 0 | ANDERSON REGIONAL MEDICAL CENTER | |
| ANDERSON HOSPITAL PROVIDERS INC | |||||||||||
| 2124 14TH STREET | MERIDIAN | MS | 39301 | 461305481 | PHYSICIAN BILLING | MS | 501(c)(3) | Line 3 | 0 | ANDERSON REGIONAL MEDICAL CENTER | |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|
| EAST MISSISSIPPI ENDOSCOPY CENTER | |||||||
| 1926 23RD AVENUE | MERIDIAN | MS | 39301 | 440884792 | HEALTHCARE | MS | N/A |
| JARMC LEVERAGE LLC | |||||||
| 2124 14TH STREET | MERIDIAN | MS | 39301 | 272284311 | INVESTMENTS | MS | N/A |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ARMC HOSPITAL PROF & GEN LLFT | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 512 22ND AVENUE | AddressLine1Txt |
| City | MERIDIAN | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 206131090 | EIN |
| Primary Activities | TRUST | PrimaryActivitiesTxt |
| Legal Domicile State | MS | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | T | EntityTypeTxt |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |