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  5. Mesaba Clinic

Mesaba Clinic

Company Details

Name: Mesaba Clinic
Jurisdiction: Minnesota
Legal type: Assumed Name
Status: Active / In Good Standing
Date formed: 30 May 2019 (6 years ago)
Company Number: cbfb0583-1383-e911-9175-00155d01b32c
File Number: 1087081500023
Principal Place of Business Address: 750 E 34th Street, Hibbing, MN 55746, USA
Mailing Address: 2450 Riverside Avenue, FCOB-1, Chief Legal Officer, Minneapolis, MN 55454, USA
ZIP code: 55746
County: St. Louis County
Place of Formation: Minnesota

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MESABA CLINIC 401(K) PROFIT SHARING PLAN 2012 411805715 2013-08-29 MESABA CLINIC 58
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-04-01
Business code 621111
Sponsor’s telephone number 2182624881
Plan sponsor’s address 750 EAST 34TH STREET, HIBBING, MN, 55746

Signature of
Role Plan administrator
Date 2013-08-29
Name of individual signing MITCH VINCENT
Valid signature Filed with authorized/valid electronic signature
MESABA CLINIC 401(K) PROFIT SHARING PLAN 2011 411805715 2012-09-26 MESABA CLINIC 64
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-04-01
Business code 621111
Sponsor’s telephone number 2182624881
Plan sponsor’s address 750 EAST 34TH STREET, HIBBING, MN, 55746

Plan administrator’s name and address
Administrator’s EIN 411805715
Plan administrator’s name MESABA CLINIC
Plan administrator’s address 750 EAST 34TH STREET, HIBBING, MN, 55746
Administrator’s telephone number 2182624881

Signature of
Role Plan administrator
Date 2012-09-26
Name of individual signing MITCH VINCENT
Valid signature Filed with authorized/valid electronic signature
MESABA CLINIC 401(K) PROFIT SHARING PLAN 2010 411805715 2011-07-28 MESABA CLINIC 67
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-04-01
Business code 621111
Sponsor’s telephone number 2182624881
Plan sponsor’s address 750 EAST 34TH STREET, HIBBING, MN, 55746

Plan administrator’s name and address
Administrator’s EIN 411805715
Plan administrator’s name MESABA CLINIC
Plan administrator’s address 750 EAST 34TH STREET, HIBBING, MN, 55746
Administrator’s telephone number 2182624881

Signature of
Role Plan administrator
Date 2011-07-28
Name of individual signing MITCH VINCENT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-28
Name of individual signing MITCH VINCENT
Valid signature Filed with authorized/valid electronic signature
MESABA CLINIC 401(K) PROFIT SHARING PLAN 2009 411805715 2010-10-05 MESABA CLINIC 67
Three-digit plan number (PN) 001
Effective date of plan 1995-04-01
Business code 621111
Sponsor’s telephone number 2182624881
Plan sponsor’s address 750 EAST 34TH STREET, HIBBING, MN, 55746

Plan administrator’s name and address
Administrator’s EIN 411805715
Plan administrator’s name MESABA CLINIC
Plan administrator’s address 750 EAST 34TH STREET, HIBBING, MN, 55746
Administrator’s telephone number 2182624881

Signature of
Role Employer/plan sponsor
Date 2010-10-05
Name of individual signing MITCHELL VINCENT
Valid signature Filed with authorized/valid electronic signature
MESABA CLINIC 401(K) PROFIT SHARING PLAN 2009 411805715 2010-10-06 MESABA CLINIC 67
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-04-01
Business code 621111
Sponsor’s telephone number 2182624881
Plan sponsor’s address 750 EAST 34TH STREET, HIBBING, MN, 55746

Plan administrator’s name and address
Administrator’s EIN 411805715
Plan administrator’s name MESABA CLINIC
Plan administrator’s address 750 EAST 34TH STREET, HIBBING, MN, 55746
Administrator’s telephone number 2182624881

Signature of
Role Plan administrator
Date 2010-10-06
Name of individual signing MITCH VINCENT
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-06
Name of individual signing MITCH VINCENT
Valid signature Filed with authorized/valid electronic signature

Aplicant

Name Role Address
Range Regional Health Services Aplicant 750 E. 34th Street, Hibbing, MN 55746

Filing

Filing Name Filing date
Original Filing - Assumed Name (Business Name: Mesaba Clinic) 2019-05-30

Related by officers

Range Regional Health Services

University Medical Center-Mesabi

Related by address

750 E 34th Street, Hibbing, MN 55746, USA

HealthLine, LLC

Date of last update: 26 Sep 2024

Sources: Minnesota's Official State Website

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