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  5. THE IRA DAVENPORT MEMORIAL HOSPITAL, INC.

THE IRA DAVENPORT MEMORIAL HOSPITAL, INC.

Company Details

Name: THE IRA DAVENPORT MEMORIAL HOSPITAL, INC.
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 03 Nov 1958 (66 years ago)
Entity Number: 114331
ZIP code: 14810
County: Steuben
Place of Formation: New York
Address: 7571 STATE ROUTE 54, BATH, NY, United States, 14810

Contact Details

Phone +1 607-776-8501

Phone +1 607-776-8500

Phone +1 607-776-8714

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
F5YYVLJ2DUV6 2025-02-18 7571 STATE ROUTE 54, BATH, NY, 14810, 9504, USA 7571 STATE ROUTE 54, BATH, NY, 14810, 9533, USA

Business Information
Doing Business As IRA DAVENPORT MEMORIAL HOSPITAL INC
URL http://www.arnothealth.org/ira-davenport-memorial-hospital
Congressional District 23
State/Country of Incorporation NY, USA
Activation Date 2024-02-21
Initial Registration Date 2005-03-31
Entity Start Date 1958-11-03
Fiscal Year End Close Date Dec 31

Service Classifications
NAICS Codes 622110
Product and Service Codes M1DA

Points of Contacts
Electronic Business
Title PRIMARY POC
Name JACQUELINE GILBERT
Role SR ACCOUNTANT
Address 600 ROE AVE, ACCOUNTING DEPT, ELMIRA, NY, 14905, 1629, USA
Government Business
Title PRIMARY POC
Name ELYSE BELLINGER
Role VP FINANCE
Address 600 ROE AVE, ACCOUNTING, ELMIRA, NY, 14905, 1629, USA
Past Performance Information not Available

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
37VU3 Active Non-Manufacturer 2005-03-31 2024-03-11 2029-02-21 2025-02-18

Contact Information
POC ELYSE BELLINGER
Phone +1 607-737-4507
Fax +1 607-271-7030
Address 7571 STATE ROUTE 54, BATH, NY, 14810 9504, 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
IRA DAVENPORT MEMORIAL HOSPITAL- EMPLOYEE PENSION PLAN 2022 160835446 2024-03-22 IRA DAVENPORT MEMORIAL HOSPITAL, INC 52
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1967-08-01
Business code 622000
Sponsor’s telephone number 6077374507
Plan sponsor’s address 7571 STATE ROUTE 54, BATH, NY, 148109504

Signature of
Role Plan administrator
Date 2024-03-18
Name of individual signing JOHN MALLIA
IRA DAVENPORT MEMORIAL HOSPITAL INC. - EMPLOYEE PENSION PLAN 2021 160835446 2023-05-15 IRA DAVENPORT MEMORIAL HOSPITAL, INC 58
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1967-08-01
Business code 622000
Sponsor’s telephone number 6077378142
Plan sponsor’s address 7571 STATE ROUTE 54, BATH, NY, 148109504

Signature of
Role Plan administrator
Date 2023-05-15
Name of individual signing THERESA REED
Role Employer/plan sponsor
Date 2023-05-15
Name of individual signing THERESA REED
IRA DAVENPORT MEMORIAL HOSPITAL INC. EMPLOYEE PENSION PLAN 2018 160835446 2020-07-15 IRA DAVENPORT MEMORIAL HOSPITAL INC 66
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1967-08-01
Business code 622000
Sponsor’s telephone number 6077768832
Plan sponsor’s address 7571 STATE ROUTE 54, BATH, NY, 148109504

Signature of
Role Plan administrator
Date 2020-07-15
Name of individual signing THERESA REED
IRA DAVENPORT MEMORIAL HOSPITAL INC. EMPLOYEE PENSION PLAN 2017 160835446 2019-05-21 IRA DAVENPORT MEMORIAL HOSPITAL, INC 77
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1967-08-01
Business code 622000
Sponsor’s telephone number 6077768832
Plan sponsor’s address 7571 STATE ROUTE 54, BATH, NY, 148109504

Signature of
Role Plan administrator
Date 2019-05-21
Name of individual signing THERESA REED
IRA DAVENPORT MEMORIAL HOSPITAL, INC. EMPLOYEE PENSION PLAN 2016 160835446 2018-05-16 IRA DAVENPORT MEMORIAL HOSPITAL, INC. 77
Three-digit plan number (PN) 001
Effective date of plan 1967-08-01
Business code 622000
Sponsor’s telephone number 6077768832
Plan sponsor’s address 7571 STATE ROUTE 54, BATH, NY, 148109504

Signature of
Role Plan administrator
Date 2018-05-16
Name of individual signing THERESA REED
IRA DAVENPORT MEMORIAL HOSPITAL, INC. EMPLOYEE PENSION PLAN 2015 160835446 2017-05-15 IRA DAVENPORT MEMORIAL HOSPITAL, INC. 84
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1967-08-01
Business code 622000
Sponsor’s telephone number 6077768832
Plan sponsor’s address 7571 STATE ROUTE 54, BATH, NY, 148109504

Plan administrator’s name and address
Administrator’s EIN 160835446
Plan administrator’s name IRA DAVENPORT MEMORIAL HOSPITAL, INC.
Plan administrator’s address 7571 STATE ROUTE 54, BATH, NY, 148109504
Administrator’s telephone number 6077768832

Signature of
Role Plan administrator
Date 2017-05-15
Name of individual signing RONALD KINTZ
Role Employer/plan sponsor
Date 2017-05-15
Name of individual signing RONALD KINTZ
IRA DAVEPORT MEMORIAL HOSPITAL, INC. EMPLOYEE PENSION PLAN 2015 160835446 2017-08-18 IRA DAVENPORT MEMORIAL HOSPITAL, INC. 84
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1967-08-01
Business code 622000
Plan sponsor’s address 7571 STATE ROUTE 54, BATH, NY, 148109504

Signature of
Role Plan administrator
Date 2017-08-18
Name of individual signing THERESA REED
Role Employer/plan sponsor
Date 2017-08-18
Name of individual signing THERESA REED
HEALTH INSURANCE PLAN OF IRA DAVENPORT MEMORIAL HOSPITAL INC. 2013 160835446 2014-04-11 IRA DAVENPORT MEMORIAL HOSPITAL INC. 148
File View Page
Three-digit plan number (PN) 503
Effective date of plan 1966-02-02
Business code 622000
Plan sponsor’s mailing address 7571 STATE ROUTE 54, BATH, NY, 14810
Plan sponsor’s address 7571 STATE ROUTE 54, BATH, NY, 14810

Number of participants as of the end of the plan year
Active participants 140

Signature of
Role Plan administrator
Date 2014-04-11
Name of individual signing THERESA STRONG
Valid signature Filed with authorized/valid electronic signature
DENTAL PLAN IRA DAVENPORT MEMORIAL HOSPITAL 2012 160835446 2014-08-20 IRA DAVENPORT MEMORIAL HOSPITAL 167
File View Page
Three-digit plan number (PN) 503
Effective date of plan 1966-02-02
Business code 622000
Plan sponsor’s mailing address 7571 STATE ROUTE 54, BATH, NY, 14810
Plan sponsor’s address 7571 STATE ROUTE 54, BATH, NY, 14810

Number of participants as of the end of the plan year
Active participants 164

Signature of
Role Plan administrator
Date 2014-08-20
Name of individual signing THERESA STRONG
Valid signature Filed with authorized/valid electronic signature
HEALTH PLAN IRA DAVENPORT MEMORIAL HOSPITAL 2012 160835446 2014-04-11 IRA DAVENPORT MEMORIAL HOSPITAL INC 154
File View Page
Three-digit plan number (PN) 503
Effective date of plan 1966-02-02
Business code 622000
Sponsor’s telephone number 6077768332
Plan sponsor’s mailing address 7571 STATE ROUTE 54, BATH, NY, 14810
Plan sponsor’s address 7571 STATE ROUTE 54, BATH, NY, 14810

Number of participants as of the end of the plan year
Active participants 148

Signature of
Role Plan administrator
Date 2014-04-11
Name of individual signing THERESA STRONG
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
N/A: THE CORP. Agent P.O.BOX 350, BATH, NY, 14810

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 7571 STATE ROUTE 54, BATH, NY, United States, 14810

Filings

Filing Number Date Filed Type Effective Date
090921000625 2009-09-21 CERTIFICATE OF AMENDMENT 2009-09-21
980805000174 1998-08-05 CERTIFICATE OF AMENDMENT 1998-08-05
C107075-2 1990-02-12 ASSUMED NAME CORP INITIAL FILING 1990-02-12
A627391-7 1979-12-13 CERTIFICATE OF AMENDMENT 1979-12-13
A96255-2 1973-08-30 CERTIFICATE OF AMENDMENT 1973-08-30
351797 1962-11-14 CERTIFICATE OF AMENDMENT 1962-11-14
129577 1958-11-03 CERTIFICATE OF CONSOLIDATION 1958-11-03

Awards

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
DO AWARD VA528FY08 2008-09-30 2008-09-30 2008-09-30
Unique Award Key CONT_AWD_VA528FY08_3600_V528A8P5294_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title ADULT DAY CARE
NAICS Code 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product and Service Codes Q401: NURSING SERVICES

Recipient Details
Recipient THE IRA DAVENPORT MEMORIAL HOSPITAL, INC.
UEI F5YYVLJ2DUV6
Legacy DUNS 073694424
Recipient Address UNITED STATES, 7571 STATE ROUTE 54, BATH, 148109504
No data IDV V528A8P5294 2008-04-01 No data No data
Unique Award Key CONT_IDV_V528A8P5294_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title ADULT DAY CARE SERVICES
NAICS Code 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product and Service Codes Q401: NURSING SERVICES

Recipient Details
Recipient THE IRA DAVENPORT MEMORIAL HOSPITAL, INC.
UEI F5YYVLJ2DUV6
Legacy DUNS 073694424
Recipient Address UNITED STATES, 7571 STATE ROUTE 54, BATH, 148109504
No data IDV VA528P0559 2009-11-01 No data No data
Unique Award Key CONT_IDV_VA528P0559_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title COLONOSCOPY SERVICES
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q505: GASTROENTEROLOGY SERVICES

Recipient Details
Recipient THE IRA DAVENPORT MEMORIAL HOSPITAL, INC.
UEI F5YYVLJ2DUV6
Legacy DUNS 073694424
Recipient Address UNITED STATES, 7571 STATE ROUTE 54, BATH, 148109533
No data IDV VA528BO0154 2009-05-13 No data No data
Unique Award Key CONT_IDV_VA528BO0154_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title MEDIAL MODEL ADULT DAY CARE
NAICS Code 624120: SERVICES FOR THE ELDERLY AND PERSONS WITH DISABILITIES
Product and Service Codes Q502: CARDIO-VASCULAR SERVICES

Recipient Details
Recipient THE IRA DAVENPORT MEMORIAL HOSPITAL, INC.
UEI F5YYVLJ2DUV6
Legacy DUNS 073694424
Recipient Address UNITED STATES, 7571 STATE ROUTE 54, BATH, 148109504
DO AWARD VA528FY0902 2009-03-31 2009-09-30 2011-09-30
Unique Award Key CONT_AWD_VA528FY0902_3600_VA528BO0154_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title MEDIAL MODEL ADULT DAY CARE
NAICS Code 624120: SERVICES FOR THE ELDERLY AND PERSONS WITH DISABILITIES
Product and Service Codes Q502: CARDIO-VASCULAR SERVICES

Recipient Details
Recipient THE IRA DAVENPORT MEMORIAL HOSPITAL, INC.
UEI F5YYVLJ2DUV6
Legacy DUNS 073694424
Recipient Address UNITED STATES, 7571 STATE ROUTE 54, BATH, 148109504
DO AWARD VA528FY0901 2008-12-31 2008-12-31 2008-12-31
Unique Award Key CONT_AWD_VA528FY0901_3600_V528A8P5294_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title ADULT DAY CARE
NAICS Code 623110: NURSING CARE FACILITIES (SKILLED NURSING FACILITIES)
Product and Service Codes Q401: NURSING SERVICES

Recipient Details
Recipient THE IRA DAVENPORT MEMORIAL HOSPITAL, INC.
UEI F5YYVLJ2DUV6
Legacy DUNS 073694424
Recipient Address UNITED STATES, 7571 STATE ROUTE 54, BATH, 148109504
DO AWARD VA528FY0901 2008-12-31 2009-09-30 2011-09-30
Unique Award Key CONT_AWD_VA528FY0901_3600_VA528BO0154_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title MEDIAL MODEL ADULT DAY CARE
NAICS Code 624120: SERVICES FOR THE ELDERLY AND PERSONS WITH DISABILITIES
Product and Service Codes Q502: CARDIO-VASCULAR SERVICES

Recipient Details
Recipient THE IRA DAVENPORT MEMORIAL HOSPITAL, INC.
UEI F5YYVLJ2DUV6
Legacy DUNS 073694424
Recipient Address UNITED STATES, 7571 STATE ROUTE 54, BATH, 148109504
DO AWARD VA5280C5001 2009-10-01 2010-09-30 2010-09-30
Unique Award Key CONT_AWD_VA5280C5001_3600_VA528BO0154_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title MEDIAL MODEL ADULT DAY CARE. DO - EXPRESS REPORT. ACTIVITY: GEC EXPENDITURES
NAICS Code 624120: SERVICES FOR THE ELDERLY AND PERSONS WITH DISABILITIES
Product and Service Codes Q502: CARDIO-VASCULAR SERVICES

Recipient Details
Recipient THE IRA DAVENPORT MEMORIAL HOSPITAL, INC.
UEI F5YYVLJ2DUV6
Legacy DUNS 073694424
Recipient Address UNITED STATES, 7571 STATE ROUTE 54, BATH, 148109504
DO AWARD VA5280C5180 2009-10-01 2011-04-30 2011-10-30
Unique Award Key CONT_AWD_VA5280C5180_3600_VA528P0559_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title COLONOSCOPY SERVICES
NAICS Code 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)
Product and Service Codes Q505: GASTROENTEROLOGY SERVICES

Recipient Details
Recipient THE IRA DAVENPORT MEMORIAL HOSPITAL, INC.
UEI F5YYVLJ2DUV6
Legacy DUNS 073694424
Recipient Address UNITED STATES, 7571 STATE ROUTE 54, BATH, 148109533
DO AWARD VA528FY11Q1Q3 2010-10-01 2011-06-30 2011-09-30
Unique Award Key CONT_AWD_VA528FY11Q1Q3_3600_VA528BO0154_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Description
Title EXPRESS REORT GEC EXPENDITURES MEDCIAL MODEL ADULT DAY CARE BATH
NAICS Code 624120: SERVICES FOR THE ELDERLY AND PERSONS WITH DISABILITIES
Product and Service Codes Q502: CARDIO-VASCULAR SERVICES

Recipient Details
Recipient THE IRA DAVENPORT MEMORIAL HOSPITAL, INC.
UEI F5YYVLJ2DUV6
Legacy DUNS 073694424
Recipient Address UNITED STATES, 7571 STATE ROUTE 54, BATH, 148109504

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Date of last update: 17 Nov 2024

Sources: New York Secretary of State

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