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CAMPBELLTON-GRACEVILLE HOSPITAL CORPORATION

CAMPBELLTON-GRACEVILLE HOSPITAL CORPORATION - Florida Company Profile

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Company Details

Entity Name:	CAMPBELLTON-GRACEVILLE HOSPITAL CORPORATION
Jurisdiction:	FLORIDA
Filing Type:	Domestic Non-Profit
Status:	Inactive The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders.
Date Filed:	19 Mar 2010 (15 years ago)
Date of dissolution:	28 Sep 2018 (7 years ago)
Last Event:	ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed:	28 Sep 2018 (7 years ago)
Document Number:	N10000002896
FEI/EIN Number	596139709 Federal Employer Identification (FEI) Number assigned by the IRS.
Address:	5429 COLLEGE DRIVE, GRACEVILLE, FL, 32440, US
Mail Address:	P.O. BOX 231, GRACEVILLE, FL, 32440, US
ZIP code:	32440
County:	Jackson
Place of Formation:	FLORIDA

Key Officers & Management

Name	Role	Address
HICKS HESTON	Chairman	1106 1st AVE, GRACEVILLE, FL, 32440
PELHAM PAT	Boar	5228 SMOKEY ROAD, GRACEVILLE, FL, 32440
JERNIGAN CHRIS	Boar	1141 10th AVE, GRACEVILLE, FL, 32440
JORDAN MICHELLE B	Agent	15112 HWY 90, CHIPLEY, FL, 32428

National Provider Identifier

NPI Number:

1306143839

Link:

View on NPI website

Authorized Person:

Name:

MR. JIMMY B RIGSBY

Role:

ADMINISTRATOR

Phone:

8502634431

Taxonomy:

Selected Taxonomy:

363LF0000X - Family Nurse Practitioner

Is Primary:

Selected Taxonomy:

207Q00000X - Family Medicine Physician

Is Primary:

Yes

Contacts:

Phone:

+1 850-263-0639

Fax:

8502639726

Events

Event Type	Filed Date	Value	Description
ADMIN DISSOLUTION FOR ANNUAL REPORT	2018-09-28	-	-
REINSTATEMENT	2017-10-23	-	-
ADMIN DISSOLUTION FOR ANNUAL REPORT	2017-09-22	-	-
CHANGE OF MAILING ADDRESS	2015-09-08	5429 COLLEGE DRIVE, GRACEVILLE, FL 32440	-
REGISTERED AGENT NAME CHANGED	2015-09-08	JORDAN, MICHELLE BLANKENSHIP	-
REGISTERED AGENT ADDRESS CHANGED	2015-09-08	15112 HWY 90, CHIPLEY, FL 32428	-

Debts

Document Number	Status	Case Number	Name of Court	Date of Entry	Expiration Date	Amount Due	Plaintiff
J19000582666	ACTIVE	1000000838856	JACKSON	2019-08-26	2029-08-28	$ 70,763.42	STATE OF FLORIDA, DEPARTMENT OF REVENUE, MARIANNA SERVICE CENTER, 4230 LAFAYETTE ST STE D, MARIANNA FL324468231
J16000682835	TERMINATED	1000000724602	LEON	2016-10-17	2026-10-21	$ 7,560.29	STATE OF FLORIDA, DEPARTMENT OF REVENUE, MARIANNA SERVICE CENTER, 4230 LAFAYETTE ST STE D, MARIANNA FL324468231
J16000323992	LAPSED	16000055CAAXMX	JACKSON COUNTY CIRCUIT COURT	2015-09-22	2021-05-26	$31,230.76	CANON FINANCIAL SERVICES, INC., 158 GAITHER DRIVE, SUITE 200, MOUNT LAUREL, NJ 08054

Documents

Name	Date
REINSTATEMENT	2017-10-23
ANNUAL REPORT	2016-03-08
ANNUAL REPORT	2015-09-08
ANNUAL REPORT	2014-02-11
ANNUAL REPORT	2013-03-22
ANNUAL REPORT	2012-02-09
ANNUAL REPORT	2011-07-05
Domestic Non-Profit	2010-03-19

Tax Exempt

Employer Identification Number (EIN) :

59-6139709

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:

1993-11

National Taxonomy Of Exempt Entities:

Health Care: Hospitals and Related Primary Medical Care Facilities

Deductibility:

Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

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Date of last update: 02 Jun 2025

Sources: Florida Department of State