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HERITAGE FAMILY MEDICINE, INC.

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Company Details

Legal Name: HERITAGE FAMILY MEDICINE, INC.
Jurisdiction: WASHINGTON
Entity Type: WA PROFIT CORPORATION
Category: DOMESTIC ENTITY
Status: Active
Formation/ Registration Date: October 4th 2002
Expiration date: 31 Oct 2025
UBI Number: 602 238 771
ZIP code: 98502
City: Olympia
County: THURSTON
Home State: WASHINGTON
Principal Office Street Address: Google Maps Logo 4001 HARRISON AVE NW, STE 101, OLYMPIA, WA, 98502-5084, UNITED STATES
Principal Office Mailing Address: Google Maps Logo PO BOX 2121, ORTING, WA, 98360-2121, UNITED STATES
Supporting healthcare providers fighting with COVID-19: $157,898

Contact Details

E-Mail: ADMIN@HERITAGEFAMILYMEDICINE.COM
Phone Number: +1 360-704-2362

Nature of Business

Health Care, Social Assistance & Service Organization

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Registered Agent Information

Name Role Address
AMANDEEP MANN Registered Agent 125 VAN SCOYOC AVE SW, ORTING, WA, 98360, UNITED STATES

Key Officers & Management

Name Role
AMANDEEP MANN Governing Person

Unique Entity ID

Unique Entity ID:
DX44QWTWN6N7
UEI Expiration Date:
2025-09-11

Business Information

Doing Business As:
HERITAGE FAMILY MEDICINE INC
Division Name:
HERITAGE FAMILY MEDICINE
Activation Date:
2024-09-13
Initial Registration Date:
2023-11-30

National Provider Identifier

NPI Number:
1427136977
Certification Date:
2021-03-26

Authorized Person:

Name:
DR. RICHARD LOUIS FAIOLA
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
3603501445

Paycheck Protection Program

Jobs Reported:
6
Initial Approval Amount:
$50,090
Date Approved:
2020-04-28
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$50,090
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$50,567.57
Servicing Lender:
Heritage Bank
Use of Proceeds:
Payroll: $50,090
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