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  5. FIRST COAST FAMILY MEDICINE, P.A.

FIRST COAST FAMILY MEDICINE, P.A. - Florida Company Profile

Company Details

Entity Name: FIRST COAST FAMILY MEDICINE, P.A.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

FIRST COAST FAMILY MEDICINE, P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act.
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 15 May 2006 (19 years ago)
Document Number: P06000067929
FEI/EIN Number 204862099

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 9130 RG SKINNER PARKWAY, JACKSONVILLE, FL, 32256, US
Mail Address: 9130 RG SKINNER PARKWAY, JACKSONVILLE, FL, 32256, US
ZIP code: 32256
County: Duval
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
FIRST COAST FAMILY MEDICINE, P.A. 401(K) PLAN 2023 204862099 2024-08-30 FIRST COAST FAMILY MEDICINE, P.A. 12
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2023-01-01
Business code 621111
Sponsor’s telephone number 9045380950
Plan sponsor’s address 9191 RG SKINNER PKWY, SUITE 603, JACKSONVILLE, FL, 32256

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name ADMINISTRATIVE GROUP, LLC DBA TAG RESOURCES
Plan administrator’s address 6501 DEANE HILL DRIVE, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2024-08-30
Name of individual signing TARA EVANS, FOR TAG RESOURCES
Valid signature Filed with authorized/valid electronic signature
FIRST COAST FAMILY MEDICINE, P.A. RETIREMENT TRUST 2018 204862099 2019-07-31 FIRST COAST FAMILY MEDICINE, P.A. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 9045380950
Plan sponsor’s address 9191 RG SKINNER PARKWAY, STE 603, JACKSONVILLE, FL, 32256

Signature of
Role Plan administrator
Date 2019-07-31
Name of individual signing PLAN SPONSOR
Valid signature Filed with authorized/valid electronic signature
FIRST COAST FAMILY MEDICINE, P.A. RETIREMENT TRUST 2017 204862099 2018-07-11 FIRST COAST FAMILY MEDICINE, P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 9045380950
Plan sponsor’s address 9191 RG SKINNER PARKWAY, SUITE 603, JACKSONVILLE, FL, 32256

Signature of
Role Plan administrator
Date 2018-07-11
Name of individual signing TERRY HASHEY
Valid signature Filed with authorized/valid electronic signature
FIRST COAST FAMILY MEDICINE, P.A. RETIREMENT TRUST 2016 204862099 2017-07-27 FIRST COAST FAMILY MEDICINE, P.A. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 9045380950
Plan sponsor’s address 9191 RG SKINNER PARKWAY, STE 603, JACKSONVILLE, FL, 32256

Signature of
Role Plan administrator
Date 2017-07-27
Name of individual signing DAN WORRELL
Valid signature Filed with authorized/valid electronic signature
FIRST COAST FAMILY MEDICINE, P.A. RETIREMENT TRUST 2015 204862099 2016-10-12 FIRST COAST FAMILY MEDICINE, P.A. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 9045380950
Plan sponsor’s address 9191 RG SKINNER PARKWAY, STE 603, JACKSONVILLE, FL, 32256

Signature of
Role Plan administrator
Date 2016-10-12
Name of individual signing DAN WORRELL
Valid signature Filed with authorized/valid electronic signature
FIRST COAST FAMILY MEDICINE, P.A. RETIREMENT TRUST 2014 204862099 2015-07-30 FIRST COAST FAMILY MEDICINE, P.A. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 9045380950
Plan sponsor’s address 9191 RG SKINNER PARKWAY, STE 603, JACKSONVILLE, FL, 32256

Signature of
Role Plan administrator
Date 2015-07-30
Name of individual signing TERRY HASHEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-07-30
Name of individual signing TERRY HASHEY
Valid signature Filed with authorized/valid electronic signature
FIRST COAST FAMILY MEDICINE, P.A. RETIREMENT TRUST 2013 204862099 2014-10-14 FIRST COAST FAMILY MEDICINE, P.A. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 621111
Sponsor’s telephone number 9045380950
Plan sponsor’s address 9191 RG SKINNER PARKWAY, STE 603, JACKSONVILLE, FL, 32256

Signature of
Role Plan administrator
Date 2014-10-14
Name of individual signing TERRY HASHEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-14
Name of individual signing TERRY HASHEY
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
HASHEY TERRY D Chief Executive Officer 9130 R G SKINNER PKWY, JACKSONVILLE, FL, 32256
HASHEY NATALIE D Vice President 9191 RG SKINNER PARKWAY, SUITE 603, JACKSONVILLE, FL, 32256
LAW OFFICES OF CHRISTOPHER L NULAND, PA Agent 4427 Herschel Street, JACKSONVILLE, FL, 32210

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2023-10-03 9130 RG SKINNER PARKWAY, JACKSONVILLE, FL 32256 -
CHANGE OF MAILING ADDRESS 2023-10-03 9130 RG SKINNER PARKWAY, JACKSONVILLE, FL 32256 -
REGISTERED AGENT ADDRESS CHANGED 2022-02-14 4427 Herschel Street, JACKSONVILLE, FL 32210 -
REGISTERED AGENT NAME CHANGED 2010-02-20 LAW OFFICES OF CHRISTOPHER L NULAND, PA -

Documents

Name Date
ANNUAL REPORT 2024-04-27
ANNUAL REPORT 2023-04-24
ANNUAL REPORT 2022-02-14
ANNUAL REPORT 2021-01-28
ANNUAL REPORT 2020-07-13
ANNUAL REPORT 2019-04-03
ANNUAL REPORT 2018-05-03
ANNUAL REPORT 2017-02-13
ANNUAL REPORT 2016-03-28
ANNUAL REPORT 2015-04-30

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
9411728305 2021-01-30 0491 PPS 9191 R G Skinner Pkwy Unit 603, Jacksonville, FL, 32256-9661
Loan Status Date 2022-03-11
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 154310
Loan Approval Amount (current) 154310
Undisbursed Amount 0
Franchise Name -
Lender Location ID 19595
Servicing Lender Name Ameris Bank
Servicing Lender Address 3490 Piedmont Rd NE, Ste 124, ATLANTA, GA, 30305
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Jacksonville, DUVAL, FL, 32256-9661
Project Congressional District FL-05
Number of Employees 11
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 19595
Originating Lender Name Ameris Bank
Originating Lender Address ATLANTA, GA
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 155899.6
Forgiveness Paid Date 2022-02-17

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Companies related by address

No other companies in our directory share the same address as FIRST COAST FAMILY MEDICINE, P.A.

Date of last update: 03 Apr 2025

Sources: Florida Department of State

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