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CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER

Company Details

Name: CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER
Jurisdiction: New York
Legal type: DOMESTIC NOT-FOR-PROFIT CORPORATION
Status: Active
Date of registration: 13 Oct 1910 (114 years ago)
Entity Number: 29737
County: Clinton
Place of Formation: New York
Address: 75 BEEKMAN STREET, PLATTSBURGH, NY, United States, 12901
Address ZIP Code: 12901

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
NAXMBLMHCLR6 2025-01-04 75 BEEKMAN ST, PLATTSBURGH, NY, 12901, 1438, USA 75 BEEKMAN ST, P.O. BOX 2868, PLATTSBURGH, NY, 12901, 1438, USA

Business Information

Doing Business As UNIVERSITY OF VERMONT HEALTH NETWORK-CHAMPLAIN VAL
URL http://www.cvph.org
Congressional District 21
State/Country of Incorporation NY, USA
Activation Date 2024-01-09
Initial Registration Date 2020-02-11
Entity Start Date 1910-10-13
Fiscal Year End Close Date Sep 30

Points of Contacts

Electronic Business
Title PRIMARY POC
Name MATEJ KOLLAR
Role CHIEF FINANCIAL OFFICER
Address 75 BEEKMAN STREET, PLATTSBURGH, NY, 12901, 1438, USA
Title ALTERNATE POC
Name ALEXANDRA MESICK
Role DIRECTOR GRANT WRITING
Address 75 BEEKMAN STREET, PLATTSBURGH, NY, 12901, USA
Government Business
Title PRIMARY POC
Name ALEXANDRA MESICK
Role DIRECTOR GRANTS
Address 75 BEEKMAN STREET, PLATTSBURGH, NY, 12901, 1438, USA
Past Performance
Title PRIMARY POC
Name ALEXANDRA MESICK
Role DIRECTOR OF GRANT WRITING
Address 75 BEEKMAN STREET, PLATTSBURGH, NY, 12901, USA

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
3NQV5 Obsolete Non-Manufacturer 2003-12-24 2024-03-10 No data 2025-01-04

Contact Information

POC ALEXANDRA MESICK
Phone +1 518-314-3534
Fax +1 518-561-0881
Address 75 BEEKMAN ST, PLATTSBURGH, NY, 12901 1438, 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
VISION INSURANCE PLAN 2021 141338471 2023-08-23 CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER 2025
File View Page
Three-digit plan number (PN) 507
Effective date of plan 2014-01-01
Business code 622000
Sponsor’s telephone number 5185627300
Plan sponsor’s mailing address 75 BEEKMAN ST, PLATTSBURGH, NY, 129011438
Plan sponsor’s address 75 BEEKMAN ST, PLATTSBURGH, NY, 129011438

Number of participants as of the end of the plan year

Active participants 0
Retired or separated participants receiving benefits 0
TOTAL HEALTH CARE PLAN EMPLOYEES AND DEPENDENTS 2021 141338471 2023-08-23 CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER 2104
File View Page
Three-digit plan number (PN) 503
Effective date of plan 1978-12-01
Business code 622000
Sponsor’s telephone number 5185627300
Plan sponsor’s mailing address 75 BEEKMAN ST, PLATTSBURGH, NY, 129011438
Plan sponsor’s address 75 BEEKMAN ST, PLATTSBURGH, NY, 129011438

Number of participants as of the end of the plan year

Active participants 0
Retired or separated participants receiving benefits 0
LIFE INSURANCE PLAN 2021 141338471 2023-08-23 CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER 2526
File View Page
Three-digit plan number (PN) 501
Effective date of plan 1972-01-01
Business code 622000
Sponsor’s telephone number 5185627300
Plan sponsor’s mailing address 75 BEEKMAN ST, PLATTSBURGH, NY, 129011438
Plan sponsor’s address 75 BEEKMAN ST, PLATTSBURGH, NY, 129011438

Number of participants as of the end of the plan year

Active participants 0
Retired or separated participants receiving benefits 0
DENTAL INSURANCE PLAN 2021 141338471 2023-08-23 CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER 1131
File View Page
Three-digit plan number (PN) 504
Effective date of plan 2012-01-01
Business code 622000
Sponsor’s telephone number 5185627300
Plan sponsor’s mailing address 75 BEEKMAN ST, PLATTSBURGH, NY, 129011438
Plan sponsor’s address 75 BEEKMAN ST, PLATTSBURGH, NY, 129011438

Number of participants as of the end of the plan year

Active participants 0
Retired or separated participants receiving benefits 0
CVPH AFLAC CANCER PLAN 2021 141338471 2023-08-23 CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER 479
File View Page
Three-digit plan number (PN) 505
Effective date of plan 2002-04-01
Business code 622000
Sponsor’s telephone number 5185627300
Plan sponsor’s mailing address 75 BEEKMAN ST, PLATTSBURGH, NY, 129011438
Plan sponsor’s address 75 BEEKMAN ST, PLATTSBURGH, NY, 129011438

Number of participants as of the end of the plan year

Active participants 0
CVPH LONG TERM DISABILITY BENEFITS PROGRAM 2021 141338471 2023-08-23 CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER 263
File View Page
Three-digit plan number (PN) 508
Effective date of plan 2016-06-01
Business code 622000
Sponsor’s telephone number 5185627300
Plan sponsor’s mailing address 75 BEEKMAN ST, PLATTSBURGH, NY, 129011438
Plan sponsor’s address 75 BEEKMAN ST, PLATTSBURGH, NY, 129011438

Number of participants as of the end of the plan year

Active participants 0
CVPH AFLAC CANCER PLAN 2021 141338471 2022-10-16 CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER 479
Three-digit plan number (PN) 505
Effective date of plan 2002-04-01
Business code 622000
Sponsor’s telephone number 5185627300
Plan sponsor’s mailing address 75 BEEKMAN ST, PLATTSBURGH, NY, 129011438
Plan sponsor’s address 75 BEEKMAN ST, PLATTSBURGH, NY, 129011438

Number of participants as of the end of the plan year

Active participants 8
CVPH LONG TERM DISABILITY BENEFITS PROGRAM 2021 141338471 2022-10-16 CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER 263
Three-digit plan number (PN) 508
Effective date of plan 2016-06-01
Business code 622000
Sponsor’s telephone number 5185627300
Plan sponsor’s mailing address 75 BEEKMAN ST, PLATTSBURGH, NY, 129011438
Plan sponsor’s address 75 BEEKMAN ST, PLATTSBURGH, NY, 129011438

Number of participants as of the end of the plan year

Active participants 230
VISION INSURANCE PLAN 2021 141338471 2022-10-17 CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER 2025
Three-digit plan number (PN) 507
Effective date of plan 2014-01-01
Business code 622000
Sponsor’s telephone number 5185627300
Plan sponsor’s mailing address 75 BEEKMAN ST, PLATTSBURGH, NY, 129011438
Plan sponsor’s address 75 BEEKMAN ST, PLATTSBURGH, NY, 129011438

Number of participants as of the end of the plan year

Active participants 1779
Retired or separated participants receiving benefits 58
DENTAL INSURANCE PLAN 2021 141338471 2022-10-17 CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER 1131
Three-digit plan number (PN) 504
Effective date of plan 2012-01-01
Business code 622000
Sponsor’s telephone number 5185627300
Plan sponsor’s mailing address 75 BEEKMAN ST, PLATTSBURGH, NY, 129011438
Plan sponsor’s address 75 BEEKMAN ST, PLATTSBURGH, NY, 129011438

Number of participants as of the end of the plan year

Active participants 1028
Retired or separated participants receiving benefits 37

DOS Process Agent

Name Role Address
THE CORPORATION DOS Process Agent 75 BEEKMAN STREET, PLATTSBURGH, NY, United States, 12901

History

Start date End date Type Value
2012-12-21 2018-01-08 Address 75 BEEKMAN STREET, PLATTSBURGH, NY, 12901, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
180108000228 2018-01-08 CERTIFICATE OF AMENDMENT 2018-01-08
121221000879 2012-12-21 CERTIFICATE OF AMENDMENT 2012-12-21
A901700-2 1982-09-10 ASSUMED NAME CORP INITIAL FILING 1982-09-10
874670-4 1970-12-11 CERTIFICATE OF AMENDMENT 1970-12-11
760770-4 1969-06-02 CERTIFICATE OF AMENDMENT 1969-06-02
626883-4 1967-07-03 CERTIFICATE OF AMENDMENT 1967-07-03
599780-12 1967-01-23 CERTIFICATE OF CONSOLIDATION 1967-01-23
18EX-288 1951-05-22 CERTIFICATE OF AMENDMENT 1951-05-22
301Q-69 1930-05-26 CERTIFICATE OF AMENDMENT 1930-05-26
252Q-89 1926-05-21 CERTIFICATE OF AMENDMENT 1926-05-21

Awards

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
PO AWARD DJBRBKIMS30020 2008-10-01 2009-09-30 2009-09-30
Unique Award Key CONT_AWD_DJBRBKIMS30020_1540_-NONE-_-NONE-
Awarding Agency Department of Justice
Link View Page

Description

Title 151060---EMERGENCY HOSPITAL SERVICES, FISCAL YEAR 2009.
NAICS Code 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS
Product and Service Codes Q526: MEDICAL/PSYCH CONSULTATION SVCS

Recipient Details

Recipient CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER
UEI NAXMBLMHCLR6
Legacy DUNS 011140741
Recipient Address UNITED STATES, 75 BEEKMAN ST, PLATTSBURGH, 129011438
BPA AWARD DJBP0212KMS30015 2011-09-14 2011-09-30 2011-09-30
Unique Award Key CONT_AWD_DJBP0212KMS30015_1540_DJBP0212BPA110002_1540
Awarding Agency Department of Justice
Link View Page

Description

Title EMERGENCY HOSPITAL SERICES FOR FISCAL YEAR 2011.
NAICS Code 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS
Product and Service Codes C114: HOSPITAL BUILDINGS

Recipient Details

Recipient CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER
UEI NAXMBLMHCLR6
Legacy DUNS 011140741
Recipient Address UNITED STATES, 75 BEEKMAN ST, PLATTSBURGH, 129011438
No data IDV DJBP0212BPA110002 2010-10-29 No data No data
Unique Award Key CONT_IDV_DJBP0212BPA110002_1540
Awarding Agency Department of Justice
Link View Page

Description

Title HOSPITAL SERVICES FOR FISCAL YEAR 2011. THIS BPA IS TO ESTABLISH AND ACCRAL FOR MEDICAL AND SURGICAL SERIVCES AT C.V.P.H. FROM 10/01/2010 - 09/30/2011. PLEASE SEE ATTACHED BPA GUIDELINES.
NAICS Code 622110: GENERAL MEDICAL AND SURGICAL HOSPITALS
Product and Service Codes AN41: HEALTH SERVICES (BASIC)

Recipient Details

Recipient CHAMPLAIN VALLEY PHYSICIANS HOSPITAL MEDICAL CENTER
UEI NAXMBLMHCLR6
Legacy DUNS 011140741
Recipient Address UNITED STATES, 75 BEEKMAN ST, PLATTSBURGH, 129011438

Date of last update: 30 Oct 2024

Sources: New York Secretary of State