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GHCH PHYSICIAN SERVICES, LLC

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Company Details

Legal Name: GHCH PHYSICIAN SERVICES, LLC
Jurisdiction: WASHINGTON
Entity Type: WA LIMITED LIABILITY COMPANY
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: June 29th 2007
Expiration date: 30 Jun 2026
UBI Number: 602 740 551
ZIP code: 98520
City: Aberdeen
County: GRAYS HARBOR
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 915 ANDERSON DR, ABERDEEN, WA, 98520-1006, UNITED STATES
Supporting healthcare providers fighting with COVID-19: $109,014

Contact Details

E-Mail: CORPORATE@OMWLAW.COM

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role
OMW R.A. SERVICES, LLC Registered Agent

Key Officers & Management

Name Role Address
TOM JENSEN Governing Person 1006 NORTH H ST, ABERDEEN, WA, 98520, UNITED STATES

National Provider Identifier

NPI Number:
1326217670
Certification Date:
2022-05-11
Link:
View on NPI website

Authorized Person:

Name:
TANYA L STOTT
Role:
HUMAN RESOURCE MANAGER
Phone:
3605376186

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
No
Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No
Selected Taxonomy:
207RC0000X - Cardiovascular Disease Physician
Is Primary:
No
Selected Taxonomy:
207RI0011X - Interventional Cardiology Physician
Is Primary:
No
Selected Taxonomy:
207V00000X - Obstetrics & Gynecology Physician
Is Primary:
No
Selected Taxonomy:
207X00000X - Orthopaedic Surgery Physician
Is Primary:
No
Selected Taxonomy:
207Y00000X - Otolaryngology Physician
Is Primary:
No
Selected Taxonomy:
208000000X - Pediatrics Physician
Is Primary:
No
Selected Taxonomy:
208800000X - Urology Physician
Is Primary:
No
Selected Taxonomy:
208600000X - Surgery Physician
Is Primary:
Yes

Contacts:

Phone:
+1 360-537-6186
Fax:
3605376192

Form 5500 Series

Employer Identification Number (EIN):
260767953
Plan Year:
2016
Number Of Participants:
111
Plan Name:
RETIREMENT PLAN
Sponsor's telephone number:
3605375119
File:
View File
Plan Administrator / Signatory:
JOSEPH VESSEY(Plan administrator)
Plan Year:
2015
Number Of Participants:
83
Plan Name:
RETIREMENT PLAN
Sponsor's telephone number:
3605375119
File:
View File
Plan Administrator / Signatory:
JOSEPH VESSEY(Plan administrator)
Plan Year:
2014
Number Of Participants:
71
Plan Name:
RETIREMENT PLAN
Sponsor's telephone number:
3605375119
File:
View File
Plan Administrator / Signatory:
JOSEPH VESSEY(Plan administrator)
Plan Year:
2013
Number Of Participants:
63
Plan Name:
RETIREMENT PLAN
Sponsor's telephone number:
3605375119
File:
View File
Plan Administrator / Signatory:
JOSEPH VESSEY(Plan administrator)
Plan Year:
2012
Number Of Participants:
49
Plan Name:
RETIREMENT PLAN
Sponsor's telephone number:
3605375119
File:
View File
Plan Administrator / Signatory:
TIMOTHY L. HOWDEN(Plan administrator)

Labor Condition Applications

Case Number:
I-200-10096-457910
Job Title:
PHYSICIAN - INTERNIST
SOC (ONET/OES) code:
29-1063.00
SOC (ONET/OES) occupation title:
Internists, General
Begin Date:
2010-07-28
End Date:
2013-07-27

Employment and Wage Information

Address:
HOQUIAM, WA
Wage Rate Paid to Nonimmigrant Workers:
$141,000
Prevailing Wage Rate:
$134,826

Related by address

915 ANDERSON DR, ABERDEEN, WA, 98520-1006, UNITED STATES

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