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  5. FAIRBANKS CLINIC, INC.

FAIRBANKS CLINIC, INC.

Contents

  • 1. Company Details
  • 2. Activities (0)
  • 3. Officers (14)
  • 4. Branches (0)
  • 5. Unique Entity ID (0)
  • 6. CIK Data (0)
  • 7. CAGE Data (0)
  • 8. LEI Data (0)
  • 9. Form 5500 (7)
  • 10. Business Licenses (0)
  • 11. Professional Licenses (0)
  • 12. Property Fairbanks (0)
  • 13. Property Ketchikan (0)
  • 14. Department of Natural Resources Records (0)
  • 15. Court Cases (0)
  • 16. Court Cases Opinions (0)
  • 17. Court View Cases (0)
  • 18. USAspending Awards (0)
  • 19. Trademarks (0)
  • 20. Lobbyist Registrations (0)
  • 21. Election Contributions (0)
  • 22. Inspections (0)
  • 23. OSHA's Inspections within Industry (0)
  • 24. Tax Exempt (0)
  • 25. Paycheck Protection Program (0)
  • 26. U.S. Small Business Administration Profile (0)
  • 27. Reviews (0)
  • 28. Related Companies by Officers (6)
  • 29. Related Companies by Addresses (2)

Company Details

Name: FAIRBANKS CLINIC, INC.
Jurisdiction: Alaska
Legal type: Professional Corporation
Status: Involuntarily Dissolved
Date of registration: 03 Jan 1969 (56 years ago)
Entity Number: 8396D
ZIP code: 99701
County: Fairbanks North Star
Place of Formation: ALASKA
Mailing Address: 607 OLD STEESE HWY B307, FAIRBANKS, AK 99701
Address: 1211 CUSHMAN ST, FAIRBANKS, AK 99701

Officers

Name Role Shares
TONY NIMEH Registered Agent -
Carl Thomas Previous Director, Previous Shareholder, Previous Treasurer, Previous Secretary 33.33
Carl Thomas Previous Director, Previous Treasurer 20.00
Carren Walters Previous Registered Agent -
DITA DE BOER Previous Registered Agent -
Enlow Walker Previous Director, Previous Shareholder, Previous Vice President 25.00
Enlow Walker Previous Director, Previous Vice President 20.00
Joan Thomas Previous Director, Previous President, Previous Shareholder, Previous Vice President 33.33
Joan Thomas Previous Director, Previous President 20.00
Joseph Worrall Previous Director, Previous Vice President 20.00

Form 5500

Plan Name Plan Year EIN/PN Received Total number of participants
FAIRBANKS CLINIC, INC. 401K PLAN 2021 920036459 2022-10-17 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-10-01
Sponsor FAIRBANKS CLINIC, INC.
Business code 621399
Sponsor’s telephone number 9073716163
Plan sponsor’s address 1111 MATTHEW CIR, NORTH POLE, AK, 997055318

Plan administrator’s name and address
Administrator’s EIN 920036459
Plan administrator’s name FAIRBANKS CLINIC, INC.
Plan administrator’s address 1111 MATTHEW CIR, NORTH POLE, AK, 997055318
Administrator’s telephone number 9073716163

Signature of
Role Plan administrator
Date 2022-10-17
Name of individual signing LETHA ARCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-10-17
Name of individual signing LETHA ARCHER
Valid signature Filed with authorized/valid electronic signature
FAIRBANKS CLINIC, INC. 401(K) PLAN 2020 920036459 2021-10-15 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-10-01
Sponsor FAIRBANKS CLINIC, INC
Business code 621399
Sponsor’s telephone number 9074521761
Plan sponsor’s address 1405 KELLUM ST STE 201, FAIRBANKS, AK, 997014189

Signature of
Role Plan administrator
Date 2021-10-15
Name of individual signing LETHA C ARCHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-10-15
Name of individual signing LETHA C ARCHER
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF FAIRBANKS CLINIC, INC. 2019 920036459 2020-05-18 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-10-01
Sponsor FAIRBANKS CLINIC, INC.
Business code 621399
Sponsor’s telephone number 9074514200
Plan sponsor’s address 1919 LATHROP ST STE 100, FAIRBANKS, AK, 997015937

Signature of
Role Plan administrator
Date 2020-05-18
Name of individual signing CARREN WALTERS
Valid signature Filed with authorized/valid electronic signature
FAIRBANKS CLINIC, INC. 401(K) PLAN 2019 920036459 2020-05-18 35
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-10-01
Sponsor FAIRBANKS CLINIC, INC.
Business code 621399
Sponsor’s telephone number 9074514200
Plan sponsor’s address 1919 LATHROP ST STE 100, FAIRBANKS, AK, 997015937

Signature of
Role Plan administrator
Date 2020-05-18
Name of individual signing CARREN WALTERS
Valid signature Filed with authorized/valid electronic signature
FAIRBANKS CLINIC, INC.401(K) PLAN 2018 920036459 2019-11-08 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-10-01
Sponsor FAIRBANKS CLINIC, INC.
Business code 621399
Sponsor’s telephone number 9074514200
Plan sponsor’s address 1919 LATHROP ST STE 100, FAIRBANKS, AK, 997015937

Signature of
Role Plan administrator
Date 2019-11-08
Name of individual signing CARREN WALTERS
Valid signature Filed with authorized/valid electronic signature
EMPLOYEE BENEFIT PLAN OF FAIRBANKS CLINIC, INC. 2018 920036459 2019-07-29 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-10-01
Sponsor FAIRBANKS CLINIC, INC.
Business code 621399
Sponsor’s telephone number 9074514200
Plan sponsor’s address 1919 LATHROP ST STE 100, FAIRBANKS, AK, 997015937

Signature of
Role Plan administrator
Date 2019-07-29
Name of individual signing CARREN WALTERS
Valid signature Filed with authorized/valid electronic signature
FAIRBANKS CLINIC, INC. 401(K) PLAN F 2017 920036459 2018-10-11 10
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-10-01
Sponsor FAIRBANKS CLINIC INC
Business code 621111
Sponsor’s telephone number 9074514200
Plan sponsor’s address 1919 LATHROP ST STE 100, FAIRBANKS, AK, 997015937

Signature of
Role Plan administrator
Date 2018-10-11
Name of individual signing CARREN WALTERS
Valid signature Filed with authorized/valid electronic signature

Date of last update: 09 Feb 2025

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

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