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  5. South Peninsula Hospital, Inc.

South Peninsula Hospital, Inc.

Contents

Company Details

Name: South Peninsula Hospital, Inc.
Jurisdiction: Alaska
Legal type: Nonprofit Corporation
Status: Good Standing
Date of registration: 01 Oct 1969 (55 years ago)
Entity Number: 8951D
ZIP code: 99603
County: Kenai Peninsula
Place of Formation: ALASKA
Address: 4300 BARTLETT ST, HOMER, AK 99603
Mailing Address: 4300 BARTLETT ST., HOMER, AK 99603

Activity

Line of Business

62 Health Care and Social Assistance

NAICS

622110 GENERAL MEDICAL AND SURGICAL HOSPITALS

Officers

Name Role
AARON WEISSER President
MATTHEW HAMBRICK Director
MARY WYTHE Secretary
CHRISTOPHER LANDESS Director
Ryan Smith Registered Agent
MICHAEL DYE Director
Walter Partridge Treasurer
Edson Knapp Director
Bernadette Wilson Director
Preston Simmons Vice President

Form 5500

Plan Name Plan Year EIN/PN Received Total number of participants
SOUTH PENINSULA HOSPITAL 403(B) PLAN FOR NON-UNION EMPLOYEES 2020 920037099 2021-06-14 118
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-01-01
Sponsor SOUTH PENINSULA HOSPITAL
Business code 622000
Sponsor’s telephone number 9072358101
Plan sponsor’s address 4300 BARTLETT STREET, HOMER, AK, 996037005

Signature of
Role Plan administrator
Date 2021-06-14
Name of individual signing ANGELA HINNEGAN
SOUTH PENINSULA HOSPITAL 403(B) PLAN FOR NON-UNION EMPLOYEES 2019 920037099 2020-10-15 116
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-01-01
Sponsor SOUTH PENINSULA HOSPITAL
Business code 622000
Sponsor’s telephone number 9072358101
Plan sponsor’s address 4300 BARTLETT STREET, HOMER, AK, 996037005

Signature of
Role Plan administrator
Date 2020-10-15
Name of individual signing ANGELA HINNEGAN
SOUTH PENINSULA HOSPITAL 403(B) PLAN FOR NON-UNION EMPLOYEES 2018 920037099 2019-10-09 105
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-01-01
Sponsor SOUTH PENINSULA HOSPITAL
Business code 622000
Sponsor’s telephone number 9072358101
Plan sponsor’s address 4300 BARTLETT STREET, HOMER, AK, 996037005

Signature of
Role Plan administrator
Date 2019-10-09
Name of individual signing JAMES BASCH
SOUTH PENINSULA HOSPITAL 403(B) PLAN FOR NON-UNION EMPLOYEES 2017 920037099 2018-10-15 79
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-01-01
Sponsor SOUTH PENINSULA HOSPITAL
Business code 622000
Sponsor’s telephone number 9072358101
Plan sponsor’s address 4300 BARTLETT STREET, HOMER, AK, 996037005

Signature of
Role Plan administrator
Date 2018-10-15
Name of individual signing ANGELA HINNEGAN
SOUTH PENINSULA HOSPITAL 403(B) PLAN FOR UNION EMPLOYEES 2016 920037099 2017-10-16 39
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2015-03-01
Sponsor SOUTH PENINSULA HOSPITAL
Business code 622000
Sponsor’s telephone number 9072358101
Plan sponsor’s address 4300 BARTLETT STREET, HOMER, AK, 996037005

Signature of
Role Plan administrator
Date 2017-10-16
Name of individual signing HOLLY TORRES
SOUTH PENINSULA HOSPITAL 403(B) PLAN FOR NON-UNION EMPLOYEES 2016 920037099 2017-10-16 81
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-01-01
Sponsor SOUTH PENINSULA HOSPITAL
Business code 622000
Sponsor’s telephone number 9072358101
Plan sponsor’s address 4300 BARTLETT STREET, HOMER, AK, 996037005

Signature of
Role Plan administrator
Date 2017-10-16
Name of individual signing HOLLY TORRES
SOUTH PENINSULA HOSPITAL 403(B) PLAN FOR NON-UNION EMPLOYEES 2015 920037099 2016-10-17 71
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-01-01
Sponsor SOUTH PENINSULA HOSPITAL
Business code 622000
Sponsor’s telephone number 9072358101
Plan sponsor’s address 4300 BARTLETT STREET, HOMER, AK, 996037005

Signature of
Role Plan administrator
Date 2016-10-17
Name of individual signing TAMMY ACKERMAN
SOUTH PENINSULA HOSPITAL 403(B) PLAN FOR UNION EMPLOYEES 2015 920037099 2016-10-17 0
File View Page
Three-digit plan number (PN) 004
Effective date of plan 2015-03-01
Sponsor SOUTH PENINSULA HOSPITAL
Business code 622000
Sponsor’s telephone number 9072358101
Plan sponsor’s address 4300 BARTLETT STREET, HOMER, AK, 996037005

Signature of
Role Plan administrator
Date 2016-10-17
Name of individual signing TAMMY ACKERMAN
SOUTH PENINSULA HOSPITAL 403(B) PLAN FOR NON-UNION EMPLOYEES 2014 920037099 2015-09-09 68
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-01-01
Sponsor SOUTH PENINSULA HOSPITAL
Business code 622000
Sponsor’s telephone number 9072358101
Plan sponsor’s address 4300 BARTLETT STREET, HOMER, AK, 996037005

Signature of
Role Plan administrator
Date 2015-09-09
Name of individual signing LORI MEYER
Role Employer/plan sponsor
Date 2015-09-09
Name of individual signing LORI MEYER
SOUTH PENINSULA HOSPITAL 403(B) PLAN FOR NON-UNION EMPLOYEES 2013 920037099 2014-01-28 68
File View Page
Three-digit plan number (PN) 003
Effective date of plan 2013-01-01
Sponsor SOUTH PENINSULA HOSPITAL
Business code 622000
Sponsor’s telephone number 9072358101
Plan sponsor’s address 4300 BARTLETT STREET, HOMER, AK, 996037005

Signature of
Role Plan administrator
Date 2014-01-28
Name of individual signing LORI MEYER
Role Employer/plan sponsor
Date 2014-01-28
Name of individual signing LORI MEYER

Licenses

Type License Number Status Date of issue Date of renewal Expiration date Description
Business License 192072 Active - 2022-10-19 2024-12-31 LOB: 62 - Health Care and Social Assistance, NAICS: 622110 - GENERAL MEDICAL AND SURGICAL HOSPITALS
Pharmacy PHAR232 Active 1992-05-07 - 2026-06-30 -
Telemedicine Business Registry 137093 Active 2018-08-07 - - -

Date of last update: 10 Jan 2025

Sources: State of Alaska - Department of Commerce, Community, and Economic Development

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