Plan Name | PROVIDENCE FAMILY MEDICAL CLINIC MEDOVA LIFESTYLE HEALTH PLAN |
Plan identification number | 501 |
401k Plan Type | Welfare Benefit |
Plan Features/Benefits |
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Company Name: | PROVIDENCE FAMILY MEDICAL |
Employer identification number (EIN): | 475288015 |
NAIC Classification: | 621111 |
NAIC Description: | Offices of Physicians (except Mental Health Specialists) |
Plan id# | Filing Submission Date | Name of Administrator | Date Administrator Signed | Name of Company Sponsor | Date Sponsor Signed |
---|---|---|---|---|---|
501 | 2021-10-01 | ROBERT MOORE | 2024-08-16 | ||
501 | 2020-10-01 | ROBERT MOORE | 2022-06-13 |