| Field | Data |
|---|---|
| EIN | 82-1080218 |
| Case Number | EO-2019084-000705 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | HEALTH MEDICAL INSTITUTE |
| Organization’s Mailing Address | 611 E CARLSON ST STE 117 |
| City | CHEYENNE |
| State | WY |
| ZIP | 82009-4335 |
| Accounting period End | 12 |
| Primary contact name | PAUL JORDAN WASHBURN |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
PAUL WASHBURN
DIRECTOR
210 SEYMOUR AVE
CHEYENNE WY 82007-1521
CORYLYNN LOPEZ
DIRECTOR
913 CLEVELAND AVE
CHEYENNE WY 82001
PETER CUMMINGS
DIRECTOR
173 CLEARFIELD DRIVE
BUFFALO NY 14221-2405
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 3/20/17 |
| Organization Incorporation State | WY |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | G90 - Medical Disciplines |
| Organization’s purpose | Charitable: No Religious: No Educational: Yes Scientific: Yes 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 | Yes |
| Unrelated Gross Income $1,000 or More | No |
| Gaming Activity | No |
| Disaster relief assistance | Yes |
| One Third Support Public | No |
| One Third Support Gifts | No |
| Benefit of College | No |
| Private Foundation 508(e) | Yes |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | Yes |
| Correctness Declaration | Yes |
| Signature Name | PAUL WASHBURN |
| Signature Title | DIRECTOR |
| Signature Date | 3/23/19 |
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