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QUARRY STREET INTERNAL MEDICINE, LLC

Company Details

Entity Name: QUARRY STREET INTERNAL MEDICINE, LLC
Jurisdiction: Connecticut
Legal type: LLC
Citizenship: Domestic
Status: Dissolved
Date Formed: 03 Jan 1994 (Companies founded in January 1994)
Date of dissolution: 21 Oct 2019
Business ALEI: 0501135
Business address: 90 QUARRY STREET, WILLIMANTIC, CT, 06226
ZIP code: 06226 (Companies in Windham, 06226)
County: Windham
Place of Formation: CONNECTICUT
E-Mail: cshooks@wcmh.org

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
QUARRY STREET INTERNAL MEDICINE 401(K) PROFIT SHARING PLAN 2017 061383831 2018-02-22 QUARRY STREET INTERNAL MEDICINE 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8604562246
Plan sponsor’s address 237 WALNUT STREET, WILLIMANTIC, CT, 06226
QUARRY STREET INTERNAL MEDICINE 401(K) PROFIT SHARING PLAN 2016 061383831 2017-04-26 QUARRY STREET INTERNAL MEDICINE 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8604562246
Plan sponsor’s address 237 WALNUT STREET, WILLIMANTIC, CT, 06226
QUARRY STREET INTERNAL MEDICINE 401(K) PROFIT SHARING PLAN 2015 061383831 2016-06-14 QUARRY STREET INTERNAL MEDICINE 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8604562246
Plan sponsor’s address 90 QUARRY STREET, WILLIMANTIC, CT, 06226
QUARRY STREET INTERNAL MEDICINE 401(K) PROFIT SHARING PLAN 2014 061383831 2015-06-16 QUARRY STREET INTERNAL MEDICINE 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8604562246
Plan sponsor’s address 90 QUARRY STREET, WILLIMANTIC, CT, 06226
QUARRY STREET INTERNAL MEDICINE 401(K) PROFIT SHARING PLAN 2013 061383831 2014-06-16 QUARRY STREET INTERNAL MEDICINE 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8604562246
Plan sponsor’s address 90 QUARRY STREET, WILLIMANTIC, CT, 06226
QUARRY STREET INTERNAL MEDICINE 401(K) PROFIT SHARING PLAN 2012 061383831 2013-06-20 QUARRY STREET INTERNAL MEDICINE 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8604562246
Plan sponsor’s address 90 QUARRY STREET, WILLIMANTIC, CT, 06226

Signature of
Role Plan administrator
Date 2013-06-20
Name of individual signing CHARLES A. SHOOKS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-06-20
Name of individual signing CHARLES A. SHOOKS
Valid signature Filed with authorized/valid electronic signature
QUARRY STREET INTERNAL MEDICINE 401(K) PROFIT SHARING PLAN 2011 061383831 2012-05-22 QUARRY STREET INTERNAL MEDICINE 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8604562246
Plan sponsor’s address 90 QUARRY STREET, WILLIMANTIC, CT, 06226

Plan administrator’s name and address
Administrator’s EIN 061383831
Plan administrator’s name QUARRY STREET INTERNAL MEDICINE
Plan administrator’s address 90 QUARRY STREET, WILLIMANTIC, CT, 06226
Administrator’s telephone number 8604562246

Signature of
Role Plan administrator
Date 2012-05-22
Name of individual signing CHARLES A. SHOOKS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-05-22
Name of individual signing CHARLES A. SHOOKS
Valid signature Filed with authorized/valid electronic signature
QUARRY STREET INTERNAL MEDICINE 401(K) PROFIT SHARING PLAN 2010 061383831 2011-06-09 QUARRY STREET INTERNAL MEDICINE 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8604562246
Plan sponsor’s address 90 QUARRY STREET, WILLIMANTIC, CT, 06226

Plan administrator’s name and address
Administrator’s EIN 061383831
Plan administrator’s name QUARRY STREET INTERNAL MEDICINE
Plan administrator’s address 90 QUARRY STREET, WILLIMANTIC, CT, 06226
Administrator’s telephone number 8604562246

Signature of
Role Plan administrator
Date 2011-06-09
Name of individual signing CHARLES A. SHOOKS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-06-09
Name of individual signing CHARLES A. SHOOKS
Valid signature Filed with authorized/valid electronic signature
QUARRY STREET INTERNAL MEDICINE 401(K) PROFIT SHARING PLAN 2009 061383831 2010-07-08 QUARRY STREET INTERNAL MEDICINE 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1994-01-01
Business code 621111
Sponsor’s telephone number 8604562246
Plan sponsor’s address 90 QUARRY STREET, WILLIMANTIC, CT, 06226

Plan administrator’s name and address
Administrator’s EIN 061383831
Plan administrator’s name QUARRY STREET INTERNAL MEDICINE
Plan administrator’s address 90 QUARRY STREET, WILLIMANTIC, CT, 06226
Administrator’s telephone number 8604562246

Signature of
Role Plan administrator
Date 2010-07-08
Name of individual signing CHARLES A. SHOOKS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-08
Name of individual signing CHARLES A. SHOOKS
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address Residence address
CHARLES A. SHOOKS Agent 237 WALNUT ST, WILLIMANTIC, CT, 06226, United States ROUTE 289, VILLAGE HILL APTS., LEBANON, CT, 06249, United States

Officer

Name Role Business address Residence address
CHARLES A. SHOOKS Officer 90 QUARRY ST., WILLIMANTIC, CT, 06226, United States ROUTE 289, VILLAGE HILL APTS., LEBANON, CT, 06249, United States

Filing

Filing number Filing date Effective date Filing category Filing type Report year
0006663994 2019-10-21 2019-10-21 Dissolution Certificate of Dissolution No data
0005798163 2017-03-21 No data Annual Report Annual Report 2016
0005798166 2017-03-21 No data Annual Report Annual Report 2017
0005797999 2017-03-20 2017-03-20 Change of Agent Agent Change No data
0005261382 2015-01-20 No data Annual Report Annual Report 2014
0005261399 2015-01-20 No data Annual Report Annual Report 2015
0005261370 2015-01-20 No data Annual Report Annual Report 2013
0004516391 2012-01-31 No data Annual Report Annual Report 2012
0004383493 2011-01-18 No data Annual Report Annual Report 2011
0004129370 2010-02-04 No data Annual Report Annual Report 2010

Related by officers

CHARLES A. SHOOKS

CHARLES A. SHOOKS, M.D., P.C.

Related by address

90 QUARRY STREET, WILLIMANTIC, CT, 06226

DR. VICTORIO TE, LLC EASTERN CONNECTICUT HEART ASSOCIATES, LLC

Date of last update: 11 Nov 2024

Sources: Connecticut's Official State Website

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