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  5. MOSCOW FAMILY MEDICINE, P.A.

MOSCOW FAMILY MEDICINE, P.A.

Company Details

Name: MOSCOW FAMILY MEDICINE, P.A.
Jurisdiction: Idaho
Legal type: Professional Service Corporation (D)
Status: Inactive-Dissolved (Administrative)
Date of registration: 21 Mar 1973 (52 years ago)
Financial Date End: 31 Mar 2020
Date dissolved: 04 Jun 2020
Entity Number: 153180
Place of Formation: IDAHO
File Number: 153180
ZIP code: 83843
County: Latah County
Mailing Address: CEO 623 S MAIN ST MOSCOW, ID 83843-2983

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MOSCOW FAMILY MEDICINE, PA EMPLOYEES' 401K PROFIT SHARING PLAN 2020 820304767 2021-04-28 MOSCOW FAMILY MEDICINE, P.A. 69
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-04-01
Business code 621111
Sponsor’s telephone number 2088822011
Plan sponsor’s address 623 S. MAIN STREET, MOSCOW, ID, 83843

Signature of
Role Plan administrator
Date 2021-04-28
Name of individual signing FRANCIS K SPAIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-04-28
Name of individual signing FRANCIS K SPAIN
Valid signature Filed with authorized/valid electronic signature
MOSCOW FAMILY MEDICINE, PA EMPLOYEES' 401K PROFIT SHARING PLAN 2020 820304767 2021-01-28 MOSCOW FAMILY MEDICINE, P.A. 110
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-04-01
Business code 621111
Sponsor’s telephone number 2088822011
Plan sponsor’s address 623 S. MAIN STREET, MOSCOW, ID, 83843

Signature of
Role Plan administrator
Date 2021-01-28
Name of individual signing FRANCIS K SPAIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-01-28
Name of individual signing FRANCIS K SPAIN
Valid signature Filed with authorized/valid electronic signature
MOSCOW FAMILY MEDICINE, PA EMPLOYEES' 401K PROFIT SHARING PLAN 2019 820304767 2020-05-21 MOSCOW FAMILY MEDICINE, P.A. 78
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-04-01
Business code 621111
Sponsor’s telephone number 2088822011
Plan sponsor’s address 623 S. MAIN STREET, MOSCOW, ID, 83843

Signature of
Role Plan administrator
Date 2020-05-21
Name of individual signing FRANCIS K SPAIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-05-21
Name of individual signing FRANCIS K SPAIN
Valid signature Filed with authorized/valid electronic signature
MOSCOW FAMILY MEDICINE, PA EMPLOYEES' 401K PROFIT SHARING PLAN 2018 820304767 2019-07-23 MOSCOW FAMILY MEDICINE, P.A. 83
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-04-01
Business code 621111
Sponsor’s telephone number 2088822011
Plan sponsor’s address 623 S. MAIN STREET, MOSCOW, ID, 83843

Signature of
Role Plan administrator
Date 2019-07-23
Name of individual signing FRANCIS K SPAIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-07-23
Name of individual signing FRANCIS K SPAIN
Valid signature Filed with authorized/valid electronic signature
MOSCOW FAMILY MEDICINE, PA EMPLOYEES' 401K PROFIT SHARING PLAN 2016 820304767 2017-04-05 MOSCOW FAMILY MEDICINE, P.A. 84
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-04-01
Business code 621111
Sponsor’s telephone number 2088822011
Plan sponsor’s address 623 S. MAIN, MOSCOW, ID, 83843

Signature of
Role Plan administrator
Date 2017-04-05
Name of individual signing FRANCIS K SPAIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-04-05
Name of individual signing FRANCIS K SPAIN
Valid signature Filed with authorized/valid electronic signature
MOSCOW FAMILY MEDICINE, PA EMPLOYEES' 401K PROFIT SHARING PLAN 2015 820304767 2016-10-03 MOSCOW FAMILY MEDICINE, P.A. 91
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-04-01
Business code 621111
Sponsor’s telephone number 2088822011
Plan sponsor’s address 623 S. MAIN, MOSCOW, ID, 83843

Signature of
Role Plan administrator
Date 2016-10-03
Name of individual signing FRANCIS K SPAIN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-03
Name of individual signing FRANCIS K SPAIN
Valid signature Filed with authorized/valid electronic signature
MOSCOW FAMILY MEDICINE, PA EMPLOYEES' 401K PROFIT SHARING PLAN 2014 820304767 2015-04-28 MOSCOW FAMILY MEDICINE, P.A. 83
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-04-01
Business code 621111
Sponsor’s telephone number 2088822011
Plan sponsor’s address 623 S. MAIN, MOSCOW, ID, 83843

Signature of
Role Plan administrator
Date 2015-04-27
Name of individual signing FRANCIS K SPAIN
Valid signature Filed with authorized/valid electronic signature
MOSCOW FAMILY MEDICINE, PA EMPLOYEES' 401K PROFIT SHARING PLAN 2013 820304767 2014-03-11 MOSCOW FAMILY MEDICINE, P.A. 79
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-04-01
Business code 621111
Sponsor’s telephone number 2088822011
Plan sponsor’s address 623 S. MAIN, MOSCOW, ID, 83843

Signature of
Role Plan administrator
Date 2014-03-10
Name of individual signing FRANCIS K SPAIN
Valid signature Filed with authorized/valid electronic signature
MOSCOW FAMILY MEDICINE, PA EMPLOYEES' 401K PROFIT SHARING PLAN 2012 820304767 2013-06-10 MOSCOW FAMILY MEDICINE, P.A. 85
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1975-04-01
Business code 621111
Sponsor’s telephone number 2088822011
Plan sponsor’s address 623 S. MAIN, MOSCOW, ID, 83843

Signature of
Role Plan administrator
Date 2013-06-10
Name of individual signing FRANCIS K SPAIN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
FRANCIS K SPAIN Agent 623 S MAIN ST, MOSCOW, ID 83843

Filing

Filing Name Filing Number Filing date
Dissolution/Revocation - Administrative 0003898079 2020-06-04
Annual Report 0003451525 2019-03-13
Annual Report 0001517111 2018-01-22
Annual Report 0001517146 2017-01-20
Change of Registered Office/Agent/Both (by Entity) 0001517109 2016-01-28
Annual Report 0001517108 2016-01-20
Annual Report 0001517106 2015-01-21
Annual Report 0001517103 2014-01-29
Change of Registered Office/Agent/Both (by Entity) 0001517101 2013-02-11
Annual Report 0001517100 2013-02-05

Related by officers

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Related by address

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Date of last update: 02 Dec 2024

Sources: Idaho Secretary of State

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