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  5. PANHANDLE FAMILY CARE ASSOCIATES, INC

PANHANDLE FAMILY CARE ASSOCIATES, INC

Company Details

Entity Name: PANHANDLE FAMILY CARE ASSOCIATES, INC
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 28 Aug 2002 (22 years ago)
Document Number: P02000093495
FEI/EIN Number 421535274
Address: 4284 KELSON AVE., MARIANNA, FL, 32446
Mail Address: 4284 KELSON AVE., MARIANNA, FL, 32446
ZIP code: 32446
County: Jackson
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1598930679 2008-04-29 2015-08-20 4284 KELSON AVE, MARIANNA, FL, 324462948, US 4284 KELSON AVE, MARIANNA, FL, 324462948, US

Contacts
Phone +1 850-482-2910
Fax 8504822836

Authorized person
Name JOHN A SPENCE
Role MD
Phone 8504822910

Taxonomy
Taxonomy Code 207Q00000X - Family Medicine Physician
Is Primary Yes

Other Provider Identifiers
Issuer BLUECROSS BLUESHIELD FLORIDA
Number 34321
State FL
Issuer MEDICARE PTAN
Number AT785
State FL
Issuer MEDICARE RAILROAD
Number DA3069
Issuer MEDICAID
Number 276272200
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PANHANDLE FAMILY CARE 401(K) PROFIT SHARING PLAN 2020 421535274 2021-06-01 PANHANDLE FAMILY CARE ASSOCIATES, INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 8504822910
Plan sponsor’s address 4284 KELSON AVE, MARIANNA, FL, 32446

Signature of
Role Plan administrator
Date 2021-06-01
Name of individual signing JOHN SPENCE
Valid signature Filed with authorized/valid electronic signature
PANHANDLE FAMILY CARE ASSOCIATES INC.401(K)PLAN 2020 421535274 2021-05-27 PANHANDLE FAMILY CARE ASSOCIATES,INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 8504822910
Plan sponsor’s address 4284 KELSON AVE, MARIANNA, FL, 32446

Signature of
Role Plan administrator
Date 2021-05-27
Name of individual signing JOHN SPENCE
Valid signature Filed with authorized/valid electronic signature
PANHANDLE FAMILY CARE ASSOCIATES, INC. CASH BALANCE PLAN 2019 421535274 2020-09-14 PANHANDLE FAMILY CARE ASSOCIATES, INC. 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 8504822910
Plan sponsor’s address 4284 KELSON AVENUE, MARIANNA, FL, 32446

Signature of
Role Plan administrator
Date 2020-09-14
Name of individual signing KRISTY BUCHANAN
Valid signature Filed with authorized/valid electronic signature
PANHANDLE FAMILY CARE ASSOCIATES, INC. CASH BALANCE PLAN 2019 421535274 2020-06-12 PANHANDLE FAMILY CARE ASSOCIATES, INC. 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 8504822910
Plan sponsor’s address 4284 KELSON AVENUE, MARIANNA, FL, 32446

Signature of
Role Plan administrator
Date 2020-06-12
Name of individual signing JOHN SPENCE
Valid signature Filed with authorized/valid electronic signature
PANHANDLE FAMILY CARE ASSOCIATES INC.401(K)PLAN 2019 421535274 2020-10-05 PANHANDLE FAMILY CARE ASSOCIATES,INC. 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 8504822910
Plan sponsor’s address 4284 KELSON AVE, MARIANNA, FL, 32446

Signature of
Role Plan administrator
Date 2020-10-05
Name of individual signing JOHN SPENCE
Valid signature Filed with authorized/valid electronic signature
PANHANDLE FAMILY CARE ASSOCIATES INC.401(K)PLAN 2018 421535274 2019-09-09 PANHANDLE FAMILY CARE ASSOCIATES,INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 8504822910
Plan sponsor’s address 4284 KELSON AVE, MARIANNA, FL, 32446

Signature of
Role Plan administrator
Date 2019-09-09
Name of individual signing JOHN SPENCE
Valid signature Filed with authorized/valid electronic signature
PANHANDLE FAMILY CARE ASSOCIATES, INC. CASH BALANCE PLAN 2018 421535274 2019-08-28 PANHANDLE FAMILY CARE ASSOCIATES, INC. 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 8504822910
Plan sponsor’s address 4284 KELSON AVENUE, MARIANNA, FL, 32446

Signature of
Role Plan administrator
Date 2019-08-28
Name of individual signing JOHN SPENCE
Valid signature Filed with authorized/valid electronic signature
PANHANDLE FAMILY CARE ASSOCIATES INC.401(K)PLAN 2017 421535274 2019-01-11 PANHANDLE FAMILY CARE ASSOCIATES,INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 8504822910
Plan sponsor’s address 4284 KELSON AVE, MARIANNA, FL, 32446

Signature of
Role Plan administrator
Date 2019-01-11
Name of individual signing JOHN SPENCE
Valid signature Filed with authorized/valid electronic signature
PANHANDLE FAMILY CARE ASSOCIATES, INC. CASH BALANCE PLAN 2017 421535274 2019-02-08 PANHANDLE FAMILY CARE ASSOCIATES, INC. 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 8504822910
Plan sponsor’s address 4284 KELSON AVENUE, MARIANNA, FL, 32446

Signature of
Role Plan administrator
Date 2019-02-08
Name of individual signing JOHN SPENCE
Valid signature Filed with authorized/valid electronic signature
PANHANDLE FAMILY CARE ASSOCIATES, INC. CASH BALANCE PLAN 2016 421535274 2018-01-19 PANHANDLE FAMILY CARE ASSOCIATES, INC. 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 8504822910
Plan sponsor’s address 4284 KELSON AVENUE, MARIANNA, FL, 32446

Signature of
Role Plan administrator
Date 2018-01-19
Name of individual signing JOHN SPENCE
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
SPENCE JOHN A Agent 2855 MAGNOLIA BLOSSOM LANE, MARIANNA, FL, 32446

President

Name Role Address
AKERSON MARK R President 5213 OAK DR., MARIANNA, FL, 32446

Vice President

Name Role Address
SPENCE JOHN A Vice President 2855 MAGNOLIA BLOSSOM LANE, MARIANNA, FL, 32446

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2020-09-25 No data No data

Related by officers

SPENCE JOHN A

PARADISE DAYCARE CENTER, INC.

Related by address

No related companies by address

Date of last update: 02 Jan 2025

Sources: Florida Department of State

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