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  5. MIDSTATE MSO, LLC

MIDSTATE MSO, LLC

Company Details

Entity Name: MIDSTATE MSO, LLC
Jurisdiction: Connecticut
Legal type: LLC
Citizenship: Domestic
Status: Dissolved
Date Formed: 14 Feb 2006
Date of dissolution: 01 Nov 2016
Business ALEI: 0848599
Business address: 435 LEWIS AVENUE, MERIDEN, CT, 06451
ZIP code: 06451
County: New Haven
Place of Formation: CONNECTICUT
E-Mail: Annamaria.Tegarini@hhchealth.org

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MIDSTATE MSO, LLC RETIREMENT PLAN 2011 204312072 2012-09-14 MIDSTATE MSO, LLC 39
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2036945582
Plan sponsor’s address 435 LEWIS AVENUE, MERIDEN, CT, 06451

Plan administrator’s name and address
Administrator’s EIN 204312072
Plan administrator’s name MIDSTATE MSO, LLC
Plan administrator’s address 435 LEWIS AVENUE, MERIDEN, CT, 06451
Administrator’s telephone number 2036945582

Signature of
Role Plan administrator
Date 2012-09-14
Name of individual signing FILIPPO CEFALY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-09-14
Name of individual signing FILIPPO CEFALY
Valid signature Filed with authorized/valid electronic signature
MIDSTATE MSO, LLC RETIREMENT PLAN 2010 204312072 2011-09-23 MIDSTATE MSO, LLC 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2036948285
Plan sponsor’s address 435 LEWIS AVENUE, MERIDEN, CT, 06451

Plan administrator’s name and address
Administrator’s EIN 204312072
Plan administrator’s name MIDSTATE MSO, LLC
Plan administrator’s address 435 LEWIS AVENUE, MERIDEN, CT, 06451
Administrator’s telephone number 2036948285

Signature of
Role Plan administrator
Date 2011-09-23
Name of individual signing FILIPPO CEFALY
Valid signature Filed with authorized/valid electronic signature
MIDSTATE MSO, LLC RETIREMENT PLAN 2009 204312072 2010-08-12 MIDSTATE MSO, LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2036948285
Plan sponsor’s address 435 LEWIS AVENUE, MERIDEN, CT, 06451

Plan administrator’s name and address
Administrator’s EIN 204312072
Plan administrator’s name MIDSTATE MSO, LLC
Plan administrator’s address 435 LEWIS AVENUE, MERIDEN, CT, 06451
Administrator’s telephone number 2036948285

Signature of
Role Plan administrator
Date 2010-08-03
Name of individual signing DANIELLE SCHNEIDER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-08-03
Name of individual signing DANIELLE SCHNEIDER
Valid signature Filed with authorized/valid electronic signature
MIDSTATE MSO, LLC RETIREMENT PLAN 2009 204312072 2010-08-03 MIDSTATE MSO, LLC 9
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2036948285
Plan sponsor’s address 435 LEWIS AVENUE, MERIDEN, CT, 06451

Plan administrator’s name and address
Administrator’s EIN 204312072
Plan administrator’s name MIDSTATE MSO, LLC
Plan administrator’s address 435 LEWIS AVENUE, MERIDEN, CT, 06451
Administrator’s telephone number 2036948285

Signature of
Role Plan administrator
Date 2010-08-03
Name of individual signing DANIELLE SCHNEIDER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-08-03
Name of individual signing DANIELLE SCHNEIDER
Valid signature Filed with authorized/valid electronic signature
MIDSTATE MSO, LLC RETIREMENT PLAN 2009 204312072 2010-06-29 MIDSTATE MSO, LLC 9
Three-digit plan number (PN) 001
Effective date of plan 2007-01-01
Business code 621111
Sponsor’s telephone number 2036948285
Plan sponsor’s address 435 LEWIS AVENUE, MERIDEN, CT, 06451

Plan administrator’s name and address
Administrator’s EIN 204312072
Plan administrator’s name MIDSTATE MSO, LLC
Plan administrator’s address 435 LEWIS AVENUE, MERIDEN, CT, 06451
Administrator’s telephone number 2036948285

Agent

Name Role
HARTFORD HEALTHCARE CORPORATION Agent

Officer

Name Role Business address Residence address
MIDSTATE MEDICAL CENTER Officer 435 LEWIS AVENUE, MERIDEN, CT, 06451, United States 435 LEWIS AVE., MERIDEN, CT, 06451, United States

Filing

Filing number Filing date Effective date Filing category Filing type Report year
0005684294 2016-10-31 2016-11-01 Dissolution Certificate of Dissolution No data
0005603203 2016-07-01 2016-07-01 Change of Agent Agent Change No data
0005084283 2014-04-11 No data Annual Report Annual Report 2014
0005075995 2014-03-24 No data Change of Agent Agent Change No data
0004780928 2013-01-14 No data Annual Report Annual Report 2013
0004509118 2012-01-23 No data Annual Report Annual Report 2012
0004431419 2011-03-18 No data Annual Report Annual Report 2011
0004211693 2010-06-03 No data Annual Report Annual Report 2010
0003901904 2009-03-03 No data Annual Report Annual Report 2009
0003704094 2008-04-30 No data Annual Report Annual Report 2008

Related by officers

MIDSTATE MEDICAL CENTER

HHC SOUTHINGTON SURGERY CENTER, LLC WALLINGFORD ENDOSCOPY CENTER, LLC

Related by address

435 LEWIS AVENUE, MERIDEN, CT, 06451

MW MEDICAL SERVICES, P.C. MWH CORPORATION LIA, LLC

Date of last update: 25 Nov 2024

Sources: Connecticut's Official State Website

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