FORM 1023-EZ for NANTICOKE HOSPITAL CENTER INC

Field Data
EIN 83-1629446
Case Number EO-2018234-000225
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NANTICOKE HOSPITAL CENTER INC
Organization’s Mailing Address 221 SKYLINE DR 208-275
City EAST STROUDSBURG
State PA
ZIP 18301
Accounting period End 12
Primary contact name SHAHID RASUL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHAHID RASUL
DIRECTOR
1129 NORTHERN BLVD SUITE 404-409
MANHASSET NY 11030

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/11/18
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E99 - Health - General and Rehabilitative N.E.C.
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 Yes
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 SHAHID RASUL
Signature Title DIRECTOR
Signature Date 8/20/18

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