FORM 1023-EZ for PRIMARY MEDICAL COMMUNITY HEALTH CENTER INC

Field Data
EIN 47-2579954
Case Number EO-2015007-000281
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PRIMARY MEDICAL COMMUNITY HEALTH CENTER INC
Organization’s Mailing Address 11500 NW 7TH AVENUE
City MIAMI
State FL
ZIP 33168
Accounting period End 12
Primary contact name PRINSTON JEAN GLAUDE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PRINSTON GLAUDE
PRESIDENT
11500 NW 7TH AVENUE
MIAMI FL 33168

Officer/Director/Trustee Two

EDWIGE GLAUDE
SECRETARY
11500 NW 7TH AVENUE
MIAMI FL 33168

Officer/Director/Trustee Three

AMEERAH ADEJOLA
TREASURER
11500 NW 7TH AVENUE
MIAMI FL 33168

Organization’s website
Organization’s email INFO@MYPRIMARYMED.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/14/2014
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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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