| Name: | CARTHAGE AREA HOSPITAL |
| Jurisdiction: | New York |
| Legal type: | DOMESTIC NOT-FOR-PROFIT CORPORATION |
| Status: | Active |
| Date of registration: | 05 Nov 1921 (103 years ago) |
| Entity Number: | 17453 |
| ZIP code: | 13619 |
| County: | Jefferson |
| Place of Formation: | New York |
| Address: | 1001 WEST STREET, CARTHAGE, NY, United States, 13619 |
| Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KP4PBJB1KBL3 | 2024-09-21 | 1001 WEST ST, CARTHAGE, NY, 13619, 9703, USA | 1001 W ST, CARTHAGE, NY, 13619, 9703, USA | |||||||||||||||||||||||||||||||||||||||||
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| Doing Business As | CARTHAGE AREA HOSPITAL INC |
| URL | www.carthagehospital.com/ |
| Congressional District | 21 |
| State/Country of Incorporation | NY, USA |
| Activation Date | 2023-09-25 |
| Initial Registration Date | 2001-11-01 |
| Entity Start Date | 1965-07-01 |
| Fiscal Year End Close Date | Dec 31 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | EMMA BEAUCHAMP |
| Address | 1001 WEST ST, CARTHAGE, NY, 13619, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | RICHARD DUVALL |
| Role | CEO |
| Address | 1001 WEST STREET, CARTHAGE, NY, 13619, USA |
| Past Performance | Information not Available |
|---|
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CARTHAGE AREA HOSPITAL WELFARE BENEFITS PLAN | 2020 | 150622079 | 2021-07-07 | CARTHAGE AREA HOSPITAL | 329 | |||||||||||||||||||||||||||||||||||||||||||
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| Active participants | 353 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 0 |
| File | View Page |
| Three-digit plan number (PN) | 520 |
| Effective date of plan | 2006-03-01 |
| Business code | 622000 |
| Sponsor’s telephone number | 3154931000 |
| Plan sponsor’s mailing address | 1001 WEST STREET, CARTHAGE, NY, 13619 |
| Plan sponsor’s address | 1001 WEST ST, CARTHAGE, NY, 136199703 |
Number of participants as of the end of the plan year
| Active participants | 329 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 0 |
| File | View Page |
| Three-digit plan number (PN) | 520 |
| Effective date of plan | 2006-03-01 |
| Business code | 622000 |
| Sponsor’s telephone number | 3154931000 |
| Plan sponsor’s mailing address | 1001 WEST STREET, CARTHAGE, NY, 13619 |
| Plan sponsor’s address | 1001 WEST ST, CARTHAGE, NY, 136199703 |
Number of participants as of the end of the plan year
| Active participants | 209 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 0 |
| File | View Page |
| Three-digit plan number (PN) | 525 |
| Effective date of plan | 2013-01-01 |
| Business code | 624100 |
| Sponsor’s telephone number | 3154931005 |
| Plan sponsor’s mailing address | 1001 WEST ST, CARTHAGE, NY, 136199703 |
| Plan sponsor’s address | 1001 WEST ST, CARTHAGE, NY, 136199703 |
Number of participants as of the end of the plan year
| Active participants | 0 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 0 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 0 |
| Number of participants with account balances as of the end of the plan year | 0 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 0 |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1974-07-01 |
| Business code | 622000 |
| Sponsor’s telephone number | 3154931000 |
| Plan sponsor’s mailing address | 1001 WEST STRET, CARTHAGE, NY, 136199703 |
| Plan sponsor’s address | 1001 WEST STRET, CARTHAGE, NY, 136199703 |
Number of participants as of the end of the plan year
| Active participants | 242 |
| Retired or separated participants receiving benefits | 81 |
| Other retired or separated participants entitled to future benefits | 244 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 21 |
Signature of
| Role | Plan administrator |
| Date | 2015-03-16 |
| Name of individual signing | RICHARD DUVALL |
| Valid signature | Filed with authorized/valid electronic signature |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1974-07-01 |
| Business code | 622000 |
| Sponsor’s telephone number | 3154931000 |
| Plan sponsor’s mailing address | 1001 WEST STRET, CARTHAGE, NY, 136199703 |
| Plan sponsor’s address | 1001 WEST STRET, CARTHAGE, NY, 136199703 |
Number of participants as of the end of the plan year
| Active participants | 242 |
| Retired or separated participants receiving benefits | 81 |
| Other retired or separated participants entitled to future benefits | 244 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 2 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 21 |
Signature of
| Role | Plan administrator |
| Date | 2014-03-19 |
| Name of individual signing | RICHARD DUVALL |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2014-03-19 |
| Name of individual signing | RICHARD DUVALL |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 1974-07-01 |
| Business code | 622000 |
| Sponsor’s telephone number | 3154931000 |
| Plan sponsor’s mailing address | 1001 WEST STREET, CARTHAGE, NY, 136199703 |
| Plan sponsor’s address | 1001 WEST STREET, CARTHAGE, NY, 136199703 |
Plan administrator’s name and address
| Administrator’s EIN | 150622079 |
| Plan administrator’s name | CARTHAGE AREA HOSPITAL |
| Plan administrator’s address | 1001 WEST STREET, CARTHAGE, NY, 136199703 |
| Administrator’s telephone number | 3154931000 |
Number of participants as of the end of the plan year
| Active participants | 267 |
| Retired or separated participants receiving benefits | 53 |
| Other retired or separated participants entitled to future benefits | 221 |
| Deceased participants whose beneficiaries are receiving or are entitled to receive benefits | 1 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 18 |
Signature of
| Role | Plan administrator |
| Date | 2011-03-16 |
| Name of individual signing | RICHARD DUVALL |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| CARTHAGE AREA HOSPITAL, INC. | Agent | WEST ST. RD., CARTHAGE, NY, 13619 |
| Name | Role | Address |
|---|---|---|
| THE CORPORATION | DOS Process Agent | 1001 WEST STREET, CARTHAGE, NY, United States, 13619 |
| Start date | End date | Type | Value |
|---|---|---|---|
| 1967-10-25 | 2019-12-13 | Name | CARTHAGE AREA HOSPITAL, INC. |
| 1962-09-14 | 1967-10-25 | Name | CARTHAGE AREA HOSPITAL ASSOCIATION |
| 1921-11-05 | 1962-09-14 | Name | CARTHAGE HOSPITAL |
| Filing Number | Date Filed | Type | Effective Date |
|---|---|---|---|
| 191213000328 | 2019-12-13 | CERTIFICATE OF AMENDMENT | 2019-12-13 |
| Z1643-2 | 1979-02-15 | ASSUMED NAME CORP INITIAL FILING | 1979-02-15 |
| A123470-3 | 1973-12-26 | CERTIFICATE OF AMENDMENT | 1973-12-26 |
| 645350-4 | 1967-10-25 | CERTIFICATE OF AMENDMENT | 1967-10-25 |
| 343252 | 1962-09-14 | CERTIFICATE OF AMENDMENT | 1962-09-14 |
| 341543 | 1962-08-31 | CERTIFICATE OF AMENDMENT | 1962-08-31 |
| 40EX-103 | 1952-05-26 | CERTIFICATE OF AMENDMENT | 1952-05-26 |
| 200Q-137 | 1921-11-05 | CERTIFICATE OF INCORPORATION | 1921-11-05 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No data | IDV | VA528P0216 | 2008-06-01 | No data | No data | |||||||||||||||||||||||||||
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| Title | MAMMOGRAPHY SERVICES |
| NAICS Code | 621512: DIAGNOSTIC IMAGING CENTERS |
| Product and Service Codes | Q522: RADIOLOGY SERVICES |
Recipient Details
| Recipient | CARTHAGE AREA HOSPITAL, INC |
| UEI | KP4PBJB1KBL3 |
| Legacy DUNS | 071603575 |
| Recipient Address | UNITED STATES, 1001 W ST, CARTHAGE, 136199776 |
| Unique Award Key | CONT_AWD_VA528C84195_3600_V528A7P2253_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Description
| Title | CBOC IN JEFFERSON COUNTY |
| NAICS Code | 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS) |
| Product and Service Codes | Q201: GENERAL HEALTH CARE SERVICES |
Recipient Details
| Recipient | CARTHAGE AREA HOSPITAL, INC |
| UEI | KP4PBJB1KBL3 |
| Legacy DUNS | 071603575 |
| Recipient Address | UNITED STATES, 1001 WEST STREET, CARTHAGE, 136199776 |
| Unique Award Key | CONT_AWD_V528C84159_3600_-NONE-_-NONE- |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Description
| Title | COMP AND PEN MENTAL/MEDICAL HEALTH EXAMS FOR THE P |
| Product and Service Codes | Q526: MEDICAL/PSYCH CONSULTATION SVCS |
Recipient Details
| Recipient | CARTHAGE AREA HOSPITAL, INC |
| UEI | KP4PBJB1KBL3 |
| Legacy DUNS | 071603575 |
| Recipient Address | UNITED STATES, 1001 W ST, CARTHAGE, 136199776 |
| Unique Award Key | CONT_AWD_W91YTZ08P0148_9700_-NONE-_-NONE- |
| Awarding Agency | Department of Defense |
| Link | View Page |
Award Amounts
| Obligated Amount | 59604.00 |
| Current Award Amount | 59604.00 |
| Potential Award Amount | 59604.00 |
Description
| Title | STERILIZATION SERVICES (NON-PERSONEL) |
| NAICS Code | 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS |
| Product and Service Codes | 6530: HOSP FURNITURE,EQ,UTENSILS & SUP |
Recipient Details
| Recipient | CARTHAGE AREA HOSPITAL, INC |
| UEI | KP4PBJB1KBL3 |
| Legacy DUNS | 071603575 |
| Recipient Address | UNITED STATES, 1001 WEST ST, CARTHAGE, JEFFERSON, NEW YORK, 136199776 |
| Unique Award Key | CONT_AWD_V528C84098_3600_V528A7P2253_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Description
| Title | TELERETINAL SERVICES |
| NAICS Code | 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS) |
| Product and Service Codes | Q511: OPHTHALMOLOGY SERVICES |
Recipient Details
| Recipient | CARTHAGE AREA HOSPITAL, INC |
| UEI | KP4PBJB1KBL3 |
| Legacy DUNS | 071603575 |
| Recipient Address | UNITED STATES, 1001 WEST STREET, CARTHAGE, 136199776 |
| Unique Award Key | CONT_AWD_W91YTZ06P0102_9700_-NONE-_-NONE- |
| Awarding Agency | Department of Defense |
| Link | View Page |
Description
| Title | PROVIDE INSTRUMENT STERILIZATION SERVICE |
| NAICS Code | 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS |
| Product and Service Codes | 6515: MED & SURGICAL INSTRUMENTS,EQ & SUP |
Recipient Details
| Recipient | CARTHAGE AREA HOSPITAL, INC |
| UEI | KP4PBJB1KBL3 |
| Legacy DUNS | 071603575 |
| Recipient Address | UNITED STATES, 1001 WEST ST, CARTHAGE, 13619 |
| Unique Award Key | CONT_AWD_W91YTZ07P0046_9700_-NONE-_-NONE- |
| Awarding Agency | Department of Defense |
| Link | View Page |
Description
| Title | NON-PERSONEL SERVICE |
| NAICS Code | 339112: SURGICAL AND MEDICAL INSTRUMENT MANUFACTURING |
| Product and Service Codes | 6530: HOSP FURNITURE,EQ,UTENSILS & SUP |
Recipient Details
| Recipient | CARTHAGE AREA HOSPITAL, INC |
| UEI | KP4PBJB1KBL3 |
| Legacy DUNS | 071603575 |
| Recipient Address | UNITED STATES, 1001 WEST ST, CARTHAGE, 136199776 |
| Unique Award Key | CONT_AWD_V528C84069_3600_V528A7P2253_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Description
| Title | CBOC IN JEFFERSON COUNTY |
| NAICS Code | 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS) |
| Product and Service Codes | Q201: GENERAL HEALTH CARE SERVICES |
Recipient Details
| Recipient | CARTHAGE AREA HOSPITAL, INC |
| UEI | KP4PBJB1KBL3 |
| Legacy DUNS | 071603575 |
| Recipient Address | UNITED STATES, 1001 WEST STREET, CARTHAGE, 136199776 |
| Unique Award Key | CONT_AWD_V5288C4033_3600_V528A7P2253_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Description
| Title | CBOC IN JEFFERSON COUNTY |
| NAICS Code | 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS) |
| Product and Service Codes | Q201: GENERAL HEALTH CARE SERVICES |
Recipient Details
| Recipient | CARTHAGE AREA HOSPITAL, INC |
| UEI | KP4PBJB1KBL3 |
| Legacy DUNS | 071603575 |
| Recipient Address | UNITED STATES, 1001 WEST STREET, CARTHAGE, 136199776 |
| Unique Award Key | CONT_AWD_VA528C94087_3600_VA528P0216_3600 |
| Awarding Agency | Department of Veterans Affairs |
| Link | View Page |
Description
| Title | MAMMOGRAPHY |
| NAICS Code | 621512: DIAGNOSTIC IMAGING CENTERS |
| Product and Service Codes | Q522: RADIOLOGY SERVICES |
Recipient Details
| Recipient | CARTHAGE AREA HOSPITAL, INC |
| UEI | KP4PBJB1KBL3 |
| Legacy DUNS | 071603575 |
| Recipient Address | UNITED STATES, 1001 W ST, CARTHAGE, 136199776 |
Date of last update: 17 Nov 2024
Sources: New York Secretary of State
