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Urgent Care at Lake Lucille, Inc.

Contents

Company Details

Name: Urgent Care at Lake Lucille, Inc.
Jurisdiction: Alaska
Legal type: Business Corporation
Status: Good Standing
Date of registration: 08 Mar 1993 (32 years ago)
Entity Number: 51299D
ZIP code: 99654
County: Matanuska Susitna
Place of Formation: ALASKA
Address: 185 E PARKS HIGHWAY , ALASKA 99654, WASLLA, AK 99654
Mailing Address: 185 E. PARKS HWY, WASILLA, AK 99654
Supporting healthcare providers fighting with COVID-19: $69,318

Activity

Line of Business

62 Health Care and Social Assistance

NAICS

621111 OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)

Officers

Name Role
Louis M Packer Shareholder
Louis M Packer Director
Louis M Packer President
Ellen R Varosi Shareholder
Ellen R Varosi Treasurer
Ellen R Varosi Director
Ellen R Varosi Secretary
Ellen R Varosi Vice President
Ellen R Varosi Registered Agent

Form 5500

Plan Name Plan Year EIN/PN Received Total number of participants
URGENT CARE AT LAKE LUCILLE, INC. 401(K) RETIREMENT PLAN 2023 920144617 2024-09-20 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-08-01
Sponsor URGENT CARE AT LAKE LUCILLE, INC.
Business code 621111
Sponsor’s telephone number 9077904111
Plan sponsor’s address 185 E. PARKS HIGHWAY, WASILLA, AK, 99654

Signature of

Role Plan administrator
Date 2024-09-20
Name of individual signing ELLEN VAROSI
Valid signature Filed with authorized/valid electronic signature
URGENT CARE AT LAKE LUCILLE, INC. 401(K) RETIREMENT PLAN 2022 920144617 2023-10-09 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-08-01
Sponsor URGENT CARE AT LAKE LUCILLE, INC.
Business code 621111
Sponsor’s telephone number 9077904111
Plan sponsor’s address 185 E. PARKS HIGHWAY, WASILLA, AK, 99654

Signature of

Role Plan administrator
Date 2023-10-09
Name of individual signing ELLEN VAROSI
URGENT CARE AT LAKE LUCILLE, INC. 401(K) RETIREMENT PLAN 2021 920144617 2022-10-12 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-08-01
Sponsor URGENT CARE AT LAKE LUCILLE, INC.
Business code 621111
Sponsor’s telephone number 9077904111
Plan sponsor’s address 185 E. PARKS HIGHWAY, WASILLA, AK, 99654

Signature of

Role Plan administrator
Date 2022-10-12
Name of individual signing ELLEN VAROSI
URGENT CARE AT LAKE LUCILLE, INC. 401(K) RETIREMENT PLAN 2020 920144617 2021-09-15 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-08-01
Sponsor URGENT CARE AT LAKE LUCILLE, INC.
Business code 621111
Sponsor’s telephone number 9077904111
Plan sponsor’s address 185 E. PARKS HIGHWAY, WASILLA, AK, 99654

Signature of

Role Plan administrator
Date 2021-09-15
Name of individual signing ELLEN VAROSI
URGENT CARE AT LAKE LUCILLE, INC. 401(K) RETIREMENT PLAN 2019 920144617 2020-09-21 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-08-01
Sponsor URGENT CARE AT LAKE LUCILLE, INC.
Business code 621111
Sponsor’s telephone number 9077904111
Plan sponsor’s address 185 E. PARKS HIGHWAY, WASILLA, AK, 99654

Signature of

Role Plan administrator
Date 2020-09-21
Name of individual signing ELLEN VAROSI
URGENT CARE AT LAKE LUCILLE, INC. 401(K) RETIREMENT PLAN 2018 920144617 2019-10-01 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-08-01
Sponsor URGENT CARE AT LAKE LUCILLE, INC.
Business code 621111
Sponsor’s telephone number 9077904111
Plan sponsor’s address 185 E. PARKS HIGHWAY, WASILLA, AK, 99654

Signature of

Role Plan administrator
Date 2019-10-01
Name of individual signing ELLEN VAROSI
URGENT CARE AT LAKE LUCILLE, INC. 401(K) RETIREMENT PLAN 2017 920144617 2018-09-21 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-08-01
Sponsor URGENT CARE AT LAKE LUCILLE, INC.
Business code 621111
Sponsor’s telephone number 9077904111
Plan sponsor’s address 185 E. PARKS HIGHWAY, WASILLA, AK, 99654

Signature of

Role Plan administrator
Date 2018-09-21
Name of individual signing ELLEN VAROSI
URGENT CARE AT LAKE LUCILLE, INC. 401(K) RETIREMENT PLAN 2016 920144617 2017-09-18 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-08-01
Sponsor URGENT CARE AT LAKE LUCILLE, INC.
Business code 621111
Sponsor’s telephone number 9077904111
Plan sponsor’s address 185 E. PARKS HIGHWAY, WASILLA, AK, 99654

Signature of

Role Plan administrator
Date 2017-09-18
Name of individual signing ELLEN VAROSI
URGENT CARE AT LAKE LUCILLE, INC. 401(K) RETIREMENT PLAN 2015 920144617 2016-09-06 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-08-01
Sponsor URGENT CARE AT LAKE LUCILLE, INC.
Business code 621111
Sponsor’s telephone number 9077904111
Plan sponsor’s address 185 E. PARKS HIGHWAY, WASILLA, AK, 99654

Signature of

Role Plan administrator
Date 2016-09-06
Name of individual signing ELLEN VAROSI
URGENT CARE AT LAKE LUCILLE, INC. 401(K) RETIREMENT PLAN 2014 920144617 2015-08-25 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-08-01
Sponsor URGENT CARE AT LAKE LUCILLE, INC.
Business code 621111
Sponsor’s telephone number 9077904111
Plan sponsor’s address 185 E. PARKS HIGHWAY, WASILLA, AK, 99654

Signature of

Role Plan administrator
Date 2015-08-25
Name of individual signing ELLEN VAROSI

Business Licenses

License Number Type Status Issue Date Date of renewal Expiration date Description
901043 Business License Active 2006-09-26 2024-10-22 2026-12-31 LOB: 62 - Health Care and Social Assistance, NAICS: 621111 - OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS)

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
345650329 1050210 2021-11-22 185 EAST PARKS HIGHWAY, WASILLA, AK, 99654
Inspection Type Complaint
Scope Partial
Safety/Health Health

Date of last update: 24 Jan 2025

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