AUBURN FAMILY MEDICAL CENTER, INC., P.S.

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Company Details

Legal Name:	AUBURN FAMILY MEDICAL CENTER, INC., P.S.
Jurisdiction:	WASHINGTON
Entity Type:	WA PROFESSIONAL SERVICE CORPORATION
Category:	DOMESTIC ENTITY
Status:	Administratively Dissolved
Formation/ Registration Date:	August 24th 1978
Date of Dissolution:	January 3rd 2019
Expiration date:	31 Aug 2018
UBI Number:	600 287 921

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Registered Agent Information

Name	Role	Address
THORSON BARNETT & MCDONALD	Registered Agent	601 UNION ST STE 3315, SEATTLE, WA, 98101-0000, UNITED STATES

Key Officers & Management

Name	Role
MICHAEL HURIAS	Governing Person
DAVID RICH	Governing Person
CHARLES WARNER	Governing Person

National Provider Identifier

NPI Number:

1427278001

Link:

View on NPI website

Authorized Person:

Name:

MRS. PEGGY DAWN THURSTON

Role:

BILLING MANAGER

Phone:

25393936043

Taxonomy:

Selected Taxonomy:

208D00000X - General Practice Physician

Is Primary:

Yes

Contacts:

Phone:

+1 253-939-3604

Fax:

2537354167

Form 5500 Series

Employer Identification Number (EIN):

911035593

Plan Year:

2013

Number Of Participants:

21

Sponsor's telephone number:

2539393604

File:

Plan Administrator / Signatory:

CHARLES WARNER(Plan administrator)

Plan Year:

2012

Number Of Participants:

22

Sponsor's telephone number:

2539393604

File:

Plan Administrator / Signatory:

CHARLES WARNER(Plan administrator)

Plan Year:

2011

Number Of Participants:

19

Sponsor's telephone number:

2539393604

File:

Plan Administrator / Signatory:

CHARLES WARNER(Plan administrator)

Plan Year:

2010

Number Of Participants:

21

Sponsor's telephone number:

2539393604

File:

Plan Administrator / Signatory:

CHARLES WARNER(Plan administrator)

Plan Year:

2009

Number Of Participants:

23

Sponsor's telephone number:

2539393604

File:

Plan Administrator / Signatory:

CHARLES WARNER(Plan administrator)

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