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CCMH CORPORATION

Company Details

Name: CCMH CORPORATION
Legal type: Kentucky Corporation
Status: Active
Standing: Good
Profit or Non-Profit: Non-profit
File Date: 16 Oct 1995 (30 years ago)
Organization Date: 16 Oct 1995 (30 years ago)
Last Annual Report: 28 Feb 2024 (a year ago)
Organization Number: 0406686
Industry: Health Services
Number of Employees: Large (100+)
ZIP code: 41008
City: Carrollton
Primary County: Carroll County
Principal Office: 309 11TH ST, CARROLLTON, KY 41008-1435
Place of Formation: KENTUCKY

Director

Name Role
DONALD GARNER Director
John Wright Director
Scott Nab Director
HERBERT KINMAN Director
Robert Yowler Director
Laman Stark Director
Harold Tomlinson Director
JAMES MONK Director
JEAN PYLES Director
Jim Stephenson Director

Incorporator

Name Role
GENE MCMURRY Incorporator

Registered Agent

Name Role
JAKE THOMPSON Registered Agent

President

Name Role
Dennis Raisor President

Secretary

Name Role
Jim Stephenson Secretary

Unique Entity ID

A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.

Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity doing business with the federal government must register for a UEI.

Unique Entity ID:
HY44RJBJ9723
CAGE Code:
51LR7
UEI Expiration Date:
2025-05-08

Business Information

Doing Business As:
CARROLL COUNTY MEMORIAL HOSPITAL
Activation Date:
2024-05-10
Initial Registration Date:
2008-04-03

National Provider Identifier

NPI Number:
1336945542
Certification Date:
2025-02-20

Authorized Person:

Name:
SHEILA TOMLINSON
Role:
DIRECTOR OF CLINICAL SERVICES
Phone:

Taxonomy:

Selected Taxonomy:
261QR1300X - Rural Health Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
5027326424

Form 5500 Series

Employer Identification Number (EIN):
611297707
Plan Year:
2012
Number Of Participants:
126
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
110
Sponsors Telephone Number:
Plan Year:
2010
Number Of Participants:
108
Sponsors Telephone Number:
Plan Year:
2009
Number Of Participants:
122
Sponsors Telephone Number:

Assumed Names

Name Status Expiration Date
CCMH OUTPATIENT PHARMACY Active 2027-03-07
Carroll County Memorial Hospital Outpatient Pharmacy Inactive 2026-12-22
EMPOWERED LIVING Inactive 2024-05-13
CARROLL COUNTY FAMILY PRACTICE Inactive 2024-02-20
CARROLL COUNTY MEMORIAL HEALTH CARE FOUNDATION Inactive 2021-05-10

Filings

Name File Date
Annual Report 2024-02-28
Registered Agent name/address change 2023-05-01
Annual Report 2023-05-01
Certificate of Assumed Name 2022-03-07
Certificate of Withdrawal of Assumed Name 2022-03-07

USAspending Awards / Contracts

Procurement Instrument Identifier:
VA249P0736
Award Or Idv Flag:
IDV
Action Obligation:
0.00
Base And All Options Value:
180000.00
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2012-06-30
Description:
RADIOLOGY SERVICES
Naics Code:
621512: DIAGNOSTIC IMAGING CENTERS
Product Or Service Code:
Q522: RADIOLOGY SERVICES
Procurement Instrument Identifier:
V603C10011
Award Or Idv Flag:
AWARD
Award Type:
DO
Action Obligation:
75000.00
Base And Exercised Options Value:
325000.00
Base And All Options Value:
325000.00
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2010-10-04
Description:
RADIOLOGY SERVICES
Naics Code:
621512: DIAGNOSTIC IMAGING CENTERS
Product Or Service Code:
Q522: RADIOLOGY SERVICES
Procurement Instrument Identifier:
V603DC1029
Award Or Idv Flag:
AWARD
Award Type:
DO
Action Obligation:
0.00
Base And Exercised Options Value:
90000.00
Base And All Options Value:
250000.00
Awarding Agency Name:
Department of Veterans Affairs
Performance Start Date:
2010-10-01
Description:
RADIOLOGY SERVICES
Naics Code:
621512: DIAGNOSTIC IMAGING CENTERS
Product Or Service Code:
Q522: RADIOLOGY SERVICES

USAspending Awards / Financial Assistance

Date:
2021-07-22
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
RURAL HEALTH CLINIC VACCINE CONFIDENCE PROGRAM
Obligated Amount:
148587.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-04-07
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:
1591000.00
Total Face Value Of Loan:
1591000.00
Date:
2016-04-07
Awarding Agency Name:
Department of Agriculture
Transaction Description:
DIRECT COMMUNITY FACILITY LOANS
Obligated Amount:
0.00
Face Value Of Loan:
5700000.00
Total Face Value Of Loan:
5700000.00
Date:
2008-06-06
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
HEALTH CARE AND OTHER FACILITIES
Obligated Amount:
284030.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00

Tax Exempt

Employer Identification Number (EIN) :
61-1297707
In Care Of Name:
% ROGER WILLIAMS
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:
1996-07
National Taxonomy Of Exempt Entities:
Health Care: Community Health Systems
Deductibility:
Type of organization and use of contribution: A supporting organization, unspecified type. Deductibility Limitation: 50% (60% for cash contributions)

Paycheck Protection Program

Date Approved:
2020-04-07
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
1591000
Current Approval Amount:
1591000
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Unanswered
Veteran:
Unanswered
Forgiveness Amount:
1601810.08

Government Spending

Branch Date of Service Fiscal Year Cabinet Department Classification Item Name Amount
Executive 2024-10-16 2025 Transportation Cabinet Public Transportation Grants Mass Transit Dvlopmnt Payments 14900
Executive 2023-09-28 2024 Justice & Public Safety Cabinet Kentucky State Police Non Pro Contract Lab Tests & Anal Fees 1099 Rep 94
Executive 2023-09-18 2024 Transportation Cabinet Public Transportation Grants Mass Transit Dvlopmnt Payments 15354
Executive 2023-07-18 2024 Transportation Cabinet Public Transportation Grants Mass Transit Dvlopmnt Payments 19573

Sources: Kentucky Secretary of State