| Field | Data |
|---|---|
| EIN | 47-3791968 |
| Case Number | EO-2015353-000036 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | FIRST NATIONS COMMUNITY HEALTHSOURCE PHARMACY |
| Organization’s Mailing Address | 5608 ZUNI RD SE |
| City | ALBUQUERQUE |
| State | NM |
| ZIP | 87108 |
| Accounting period End | 9 |
| Primary contact name | LEON PABOUCEK |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
TASSY PARKER
PRESIDENT / CHAIR PERSON
1336 LAFAYETTE DR NE
ALBUQUERQUE NM 87106
ANGELITA BENALLY
VICE PRESIDENT
901 EAST BUENA VISTA
GALLUP NM 87301
JOYCE HUDSON
SECRETARY
PO BOX 34
GALLUP NM 87305
JANET PACHECO-MORTON
TREASURER
8 OFNNY LANE
SANTA CRUZ NM 87567
MELISSA PARRA
MEMBER
13408 CEDAR BROOK RD NE
ALBUQUERQUE NM 87111
| Organization’s website | FNCH.ORG |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 8/28/1985 |
| Organization Incorporation State | NM |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E32 - Ambulatory Health Center, Community Clinic |
| Organization’s purpose | Charitable: Yes Religious: No Educational: No Scientific: No Literary: No Public Safety: No Amateur Sports: No Cruelty Prevention: No |
| Qualify For Exemption | No |
| Legislation influence | No |
| Compensation of Officer director trustee | No |
| Donation of funds | No |
| Conducting Activities Outside of United States | No |
| Financial transactions with officers | No |
| Unrelated Gross Income $1,000 or More | No |
| Gaming Activity | No |
| Disaster relief assistance | No |
| One Third Support Public | No |
| One Third Support Gifts | Yes |
| Benefit of College | No |
| Private Foundation 508(e) | No |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | |
| Signature Title | |
| Signature Date |
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