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BOWLING GREEN-WARREN COUNTY PRIMARY CARE CENTER, INC.

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Company Details

Name: BOWLING GREEN-WARREN COUNTY PRIMARY CARE CENTER, INC.
Legal type: Kentucky Corporation
Status: Active
Standing: Good
Profit or Non-Profit: Non-profit
File Date: 28 May 1987 (38 years ago)
Organization Date: 28 May 1987 (38 years ago)
Last Annual Report: 05 Feb 2025 (5 months ago)
Organization Number: 0229752
Industry: Health Services
Number of Employees: Medium (20-99)
ZIP code: 42102
City: Bowling Green
Primary County: Warren County
Principal Office: 225 NATCHEZ TRACE AVENUE, P O BOX 1177, BOWLING GREEN, KY 42102-1177
Place of Formation: KENTUCKY

President

Name Role
Charles Wallace President

Vice President

Name Role
April Baker Vice President

Secretary

Name Role
Brandy Zachery Secretary

Treasurer

Name Role
David Sparks Treasurer

Director

Name Role
Charles Wallace Sr. Director
Michelle Cole Director
April Baker Director
David Sparks Director
Michael Hubbard Director
Janice Brady Director
Vicki Beach Director
Brandy Zachery Director
Liana Sandlin Director
Lori Mitts Director

Registered Agent

Name Role
JOHN LILLYBRIDGE Registered Agent

Incorporator

Name Role
CHARLES D. BUNCH Incorporator

Unique Entity ID

Unique Entity ID:
C166A3KB66Y1
CAGE Code:
3LNN1
UEI Expiration Date:
2026-01-24

Business Information

Activation Date:
2025-01-28
Initial Registration Date:
2003-11-11

Commercial and government entity program

CAGE number:
3LNN1
Status:
Obsolete
Type:
Non-Manufacturer
CAGE Update Date:
2025-01-28
SAM Expiration:
2026-01-24

Contact Information

POC:
JOHN LILLYBRIDGE

National Provider Identifier

NPI Number:
1336268234
Certification Date:
2022-05-12

Authorized Person:

Name:
MS. AMY WHITTINGHILL
Role:
COO
Phone:

Taxonomy:

Selected Taxonomy:
261QF0400X - Federally Qualified Health Center (FQHC)
Is Primary:
Yes

Contacts:

Fax:
2707834081

Legal Entity Identifier

LEI Number:
549300S8XHWEWWHNOB46

Registration Details:

Initial Registration Date:
2018-04-26
Next Renewal Date:
2023-10-18
Registration Status:
LAPSED
Validation Source:
FULLY_CORROBORATED

Form 5500 Series

Employer Identification Number (EIN):
611386859
Plan Year:
2016
Number Of Participants:
69
Sponsors Telephone Number:

Assumed Names

Name Status Expiration Date
THE FAIRVIEW COMMUNITY HEALTH CENTER Inactive 2021-02-16

Filings

Name File Date
Annual Report 2025-02-05
Annual Report 2024-05-15
Annual Report 2023-03-16
Annual Report 2022-03-03
Annual Report 2021-02-09

USAspending Awards / Financial Assistance

Date:
2023-08-29
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
FY 2023 BRIDGE ACCESS PROGRAM
Obligated Amount:
29526.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2023-03-07
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
FY 2023 EXPANDING COVID-19 VACCINATION
Obligated Amount:
0.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2021-03-27
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
AMERICAN RESCUE PLAN ACT FUNDING FOR HEALTH CENTERS
Obligated Amount:
2602625.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-05-05
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
FY 2020 EXPANDING CAPACITY FOR CORONAVIRUS TESTING (ECT)
Obligated Amount:
292684.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-04-14
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
800600.00
Total Face Value Of Loan:
800600.00

Tax Exempt

Employer Identification Number (EIN) :
61-1386859
In Care Of Name:
% JOHN LILLYBRIDGE
Classification:
Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Ruling Date:
2001-09
National Taxonomy Of Exempt Entities:
Education: Education N.E.C.
Deductibility:
Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Paycheck Protection Program

Jobs Reported:
93
Initial Approval Amount:
$800,600
Date Approved:
2020-04-13
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Current Approval Amount:
$800,600
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
$805,270.17
Servicing Lender:
Truist Bank
Use of Proceeds:
Payroll: $800,600

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Sources: Kentucky Secretary of State