Entity Number 28260D
Status Good Standing
NameBETHEL FAMILY CLINIC
Date of registration 01 Nov 1982 (42 years ago) 01 Nov 1982
Legal typeNonprofit Corporation
Place of FormationALASKA
Address 631 MAIN ST, BETHEL, AK 99559
Address ZIP code 99559
Mailing Address PO BOX 1908, BETHEL, AK 99559-1908
Mailing Address ZIP code 99559-1908
Line of Business
62 Health Care and Social AssistanceNAICS
621498 ALL OTHER OUTPATIENT CARE CENTERSYLNGDQKYAT95
2025-04-03
631 MAIN ST, BETHEL, AK, 99559, USA
BOX 1908, BETHEL, AK, 99559, 1908, USA
Business Information
| URL | www.bethelfamilyclinic.org |
| Division Name | BETHEL FAMILY CLINIC |
| Congressional District | 00 |
| State/Country of Incorporation | AK, USA |
| Activation Date | 2024-04-05 |
| Initial Registration Date | 2006-08-04 |
| Entity Start Date | 1982-11-01 |
| Fiscal Year End Close Date | Dec 31 |
Points of Contacts
| Electronic Business | |
|---|---|
| Title | PRIMARY POC |
| Name | MOHAMMAD ENAYET CHOWDHURY |
| Address | PO BOX 1908, BETHEL, AK, 99559, 1908, USA |
| Title | ALTERNATE POC |
| Name | VALERA BRICKEL |
| Address | PO BOX 1908, BETHEL, AK, 99559, 1908, USA |
| Government Business | |
|---|---|
| Title | PRIMARY POC |
| Name | MOHAMMAD ENAYET CHOWDHURY |
| Address | PO BOX 1908, BETHEL, AK, 99559, 1908, USA |
| Title | ALTERNATE POC |
| Name | VALERA BRICKEL |
| Address | PO BOX 1908, BETHEL, AK, 99559, 1908, USA |
| Past Performance | |
|---|---|
| Title | PRIMARY POC |
| Name | MOHAMMAD ENAYET CHOWDHURY |
| Address | PO BOX 1908, BETHEL, AK, 99559, 1908, USA |
| Title | ALTERNATE POC |
| Name | VALERA BRICKEL |
| Address | PO BOX 1908, BETHEL, AK, 99559, 1908, USA |
4HAG0
Obsolete
Non-Manufacturer
2006-08-07
2024-04-05
2025-04-03
Contact Information
| POC | MOHAMMAD ENAYET CHOWDHURY |
| Phone | +1 907-543-9851 |
| Fax | +1 907-543-9859 |
| Address | 631 MAIN ST, BETHEL, AK, 99559, 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 |
|---|
SAFE-HARBOR 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BETHEL FAMILY CLINIC
2023
920089260
2024-07-08
BETHEL FAMILY CLINIC
20
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-01-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 9075433773 |
| Plan sponsor’s address | PO BOX 1908, BETHEL, AK, 995591908 |
Signature of
| Role | Plan administrator |
| Date | 2024-07-08 |
| Name of individual signing | MOHAMMAD ENAYET CHOWDHURY |
SAFE-HARBOR 401(K) PROFIT SHARING PLAN FOR EMPLOYEES OF BETHEL FAMILY CLINIC
2022
920089260
2023-07-06
BETHEL FAMILY CLINIC
22
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-01-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 9075433773 |
| Plan sponsor’s address | PO BOX 1908, BETHEL, AK, 995591908 |
Signature of
| Role | Plan administrator |
| Date | 2023-07-06 |
| Name of individual signing | MOHAMMAD ENAYET CHOWDHURY |
EMPLOYEE BENEFIT PLAN OF BETHEL FAMILY CLINIC
2021
920089260
2022-08-30
BETHEL FAMILY CLINIC
20
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-01-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 9075433773 |
| Plan sponsor’s address | PO BOX 1908, BETHEL, AK, 995591908 |
Signature of
| Role | Plan administrator |
| Date | 2022-08-30 |
| Name of individual signing | MOHAMMAD ENAYET CHOWDHURY |
EMPLOYEE BENEFIT PLAN OF BETHEL FAMILY CLINIC
2020
920089260
2021-02-25
BETHEL FAMILY CLINIC
20
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-01-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 9075433773 |
| Plan sponsor’s address | PO BOX 1908, BETHEL, AK, 995591908 |
Signature of
| Role | Plan administrator |
| Date | 2021-02-25 |
| Name of individual signing | DON BLACK |
EMPLOYEE BENEFIT PLAN OF BETHEL FAMILY CLINIC
2019
920089260
2020-07-29
BETHEL FAMILY CLINIC
14
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-01-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 9075433773 |
| Plan sponsor’s address | PO BOX 1908, BETHEL, AK, 995591908 |
Signature of
| Role | Plan administrator |
| Date | 2020-07-29 |
| Name of individual signing | DON BLACK |
EMPLOYEE BENEFIT PLAN OF BETHEL FAMILY CLINIC
2018
920089260
2019-06-14
BETHEL FAMILY CLINIC
15
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-01-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 9075433773 |
| Plan sponsor’s address | PO BOX 1908, BETHEL, AK, 995591908 |
Signature of
| Role | Plan administrator |
| Date | 2019-06-14 |
| Name of individual signing | MARY LARAUX |
EMPLOYEE BENEFIT PLAN OF BETHEL FAMILY CLINIC
2017
920089260
2018-10-05
BETHEL FAMILY CLINIC
15
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-01-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 9075433773 |
| Plan sponsor’s address | PO BOX 1908, BETHEL, AK, 995591908 |
Signature of
| Role | Plan administrator |
| Date | 2018-10-05 |
| Name of individual signing | JEHONA KADRIU |
EMPLOYEE BENEFIT PLAN OF BETHEL FAMILY CLINIC BETHEL FAMILY CLINIC
2016
920089260
2017-07-18
BETHEL FAMILY CLINIC
0
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-01-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 9075433773 |
| Plan sponsor’s address | 631 MAIN STREET, BETHEL, AK, 99559 |
Signature of
| Role | Plan administrator |
| Date | 2017-07-18 |
| Name of individual signing | LATESIA GUINN |
| Role | Employer/plan sponsor |
| Date | 2017-07-18 |
| Name of individual signing | LATESIA GUINN |
BETHEL FAMILY CLINIC 401(K) P/S PLAN
2015
920089260
2016-02-17
BETHEL FAMILY CLINIC
10
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-01-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 9075433773 |
| Plan sponsor’s address | 631 MAIN ST., BETHEL, AK, 99559 |
Plan administrator’s name and address
| Administrator’s EIN | 920089260 |
| Plan administrator’s name | BETHEL FAMILY CLINIC |
| Plan administrator’s address | 631 MAIN ST., BETHEL, AK, 99559 |
| Administrator’s telephone number | 9075433773 |
Signature of
| Role | Plan administrator |
| Date | 2016-02-17 |
| Name of individual signing | LATESIA GUINN |
BETHEL FAMILY CLINIC 401(K) P/S PLAN
2014
920089260
2015-04-16
BETHEL FAMILY CLINIC
8
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2007-01-01 |
| Business code | 621112 |
| Sponsor’s telephone number | 9075433773 |
| Plan sponsor’s address | 631 MAIN ST., BETHEL, AK, 99559 |
Plan administrator’s name and address
| Administrator’s EIN | 920089260 |
| Plan administrator’s name | BETHEL FAMILY CLINIC |
| Plan administrator’s address | 631 MAIN ST., BETHEL, AK, 99559 |
| Administrator’s telephone number | 9075433773 |
Signature of
| Role | Plan administrator |
| Date | 2015-04-16 |
| Name of individual signing | LATESIA GUINN |
SUSAN TAYLOR
Treasurer
Charlene Wuya
Director
Jody Brand
Director
Gloria Benson
Director
Rebecca Lanham
Director
Elondre Johnson
Director
Dean Swope
President
Minnie Fritts
Vice President
Jessica Haines
Secretary
MOHAMMAD CHOWDHURY
Registered Agent
Business License
308552
Active
2005-02-09
2022-11-30
2024-12-31
LOB: 62 - Health Care and Social Assistance, NAICS: 621498 - ALL OTHER OUTPATIENT CARE CENTERS
Date of last update: 26 Aug 2024
Sources
