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  5. PHS West, Inc.

PHS West, Inc.

Company Details

Name: PHS West, Inc.
Jurisdiction: Minnesota
Legal type: Business Corporation (Domestic)
Status: Inactive
Date formed: 22 Sep 1995 (29 years ago)
Company Number: 0166cb81-abd4-e011-a886-001ec94ffe7f
File Number: 8W-148
Registered Office Address: 6704 Bleck Drive, Rockford, MN 55373, USA
Principal Executive Office Address: 6704 Bleck Dr, Rockford, MN 55373, United States
ZIP code: 55373
County: Hennepin County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PHS WEST, INC. 401(K) PLAN 2021 411823862 2022-05-12 PHS WEST, INC. 41
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 423400
Sponsor’s telephone number 7634987576
Plan sponsor’s address 6704 BLECK DRIVE, ROCKFORD, MN, 55373

Signature of
Role Plan administrator
Date 2022-05-12
Name of individual signing DON DEMORETT
Valid signature Filed with authorized/valid electronic signature
PHS WEST, INC. 401(K) PLAN 2020 411823862 2021-06-29 PHS WEST, INC. 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 423400
Sponsor’s telephone number 7634987576
Plan sponsor’s address 6704 BLECK DRIVE, ROCKFORD, MN, 55373

Signature of
Role Plan administrator
Date 2021-06-29
Name of individual signing DON DEMORETT
Valid signature Filed with authorized/valid electronic signature
PHS WEST, INC. 401(K) PLAN 2019 411823862 2020-07-06 PHS WEST, INC. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 423400
Sponsor’s telephone number 7634987576
Plan sponsor’s address 6704 BLECK DRIVE, ROCKFORD, MN, 55373

Signature of
Role Plan administrator
Date 2020-07-06
Name of individual signing CAROL OLIN
Valid signature Filed with authorized/valid electronic signature
PHS WEST, INC. 401(K) PLAN 2018 411823862 2019-07-18 PHS WEST, INC. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 423400
Sponsor’s telephone number 7634987576
Plan sponsor’s address 6704 BLECK DRIVE, ROCKFORD, MN, 55373

Signature of
Role Plan administrator
Date 2019-07-18
Name of individual signing CAROL OLIN
Valid signature Filed with authorized/valid electronic signature
PHS WEST, INC. 401(K) PLAN 2017 411823862 2018-07-10 PHS WEST, INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 423400
Sponsor’s telephone number 7634987576
Plan sponsor’s address 6704 BLECK DRIVE, ROCKFORD, MN, 55373

Signature of
Role Plan administrator
Date 2018-07-10
Name of individual signing CAROL OLIN
Valid signature Filed with authorized/valid electronic signature
PHS WEST, INC. 401(K) PLAN 2016 411823862 2017-07-13 PHS WEST, INC. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 423400
Sponsor’s telephone number 7634987576
Plan sponsor’s address 6704 BLECK DRIVE, ROCKFORD, MN, 55373

Signature of
Role Plan administrator
Date 2017-07-13
Name of individual signing CAROL OLIN
Valid signature Filed with authorized/valid electronic signature
PHS WEST, INC. 401(K) PLAN 2015 411823862 2016-06-23 PHS WEST, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 423400
Sponsor’s telephone number 7634987576
Plan sponsor’s address 6704 BLECK DRIVE, ROCKFORD, MN, 55373

Signature of
Role Plan administrator
Date 2016-06-23
Name of individual signing CAROL OLIN
Valid signature Filed with authorized/valid electronic signature
PHS WEST, INC. 401(K) PLAN 2014 411823862 2015-06-16 PHS WEST, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 423400
Sponsor’s telephone number 7634987576
Plan sponsor’s address 11283 RIVER ROAD NE, PO BOX 246, HANOVER, MN, 55341

Signature of
Role Plan administrator
Date 2015-06-16
Name of individual signing CAROL OLIN
Valid signature Filed with authorized/valid electronic signature
PHS WEST, INC. 401(K) PLAN 2013 411823862 2014-05-22 PHS WEST, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 423400
Sponsor’s telephone number 7634987576
Plan sponsor’s address 11283 RIVER ROAD NE, PO BOX 246, HANOVER, MN, 55341

Signature of
Role Plan administrator
Date 2014-05-22
Name of individual signing CAROL OLIN
Valid signature Filed with authorized/valid electronic signature
PHS WEST, INC. 401(K) PLAN 2012 411823862 2013-06-25 PHS WEST, INC. 14
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 423400
Sponsor’s telephone number 7634987576
Plan sponsor’s address 11283 RIVER ROAD NE, PO BOX 246, HANOVER, MN, 55341

Signature of
Role Plan administrator
Date 2013-06-25
Name of individual signing CAROL OLIN
Valid signature Filed with authorized/valid electronic signature

Chief Executive Officer

Name Role Address
Daniel Cummings Chief Executive Officer 6704 Bleck Dr, Rockford, MN 55373, United States

Filing

Filing Name Filing date
Merger Non Survivor - Business Corporation (Domestic) 2021-05-13
Registered Office and/or Agent - Business Corporation (Domestic) 2020-10-09
Merger Survivor - Business Corporation (Domestic) 2020-06-23
Original Filing - Business Corporation (Domestic) (Business Name: PHS West, Inc.) 1995-09-22

Related by officers

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Related by address

6704 Bleck Dr, Rockford, MN 55373, United States

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Date of last update: 05 Jan 2025

Sources: Minnesota's Official State Website

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