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  5. MEDSERV OF CONNECTICUT, INC.

MEDSERV OF CONNECTICUT, INC.

Company Details

Entity Name: MEDSERV OF CONNECTICUT, INC.
Jurisdiction: Connecticut
Legal type: Stock
Citizenship: Domestic
Status: Dissolved
Date Formed: 19 Jun 1995
Date of dissolution: 31 Dec 2016
Business ALEI: 0513210
Annual report due: 17 Jun 2017
Business address: 1290 SILAS DEANE HIGHWAY 3C, WETHERSFIELD, CT, 06109
ZIP code: 06109
County: Hartford
Place of Formation: CONNECTICUT
Total authorized shares: 20000
E-Mail: bking@medservct.com

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
MEDSERV OF CONNECTICUT, INC. SAVINGS PLAN 2016 061428595 2017-03-08 MEDSERV OF CONNECTICUT, INC. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-09-01
Business code 621399
Sponsor’s telephone number 2036992400
Plan sponsor’s address HCMA/NHCMA, 1290 SILAS DEANE HIGHWAY, SUITE 3C, WETHERSFIELD, CT, 061094337
MEDSERV OF CONNECTICUT, INC. SAVINGS PLAN 2016 061428595 2017-05-15 MEDSERV OF CONNECTICUT, INC. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-09-01
Business code 621399
Sponsor’s telephone number 2036992400
Plan sponsor’s address HCMA/NHCMA, 1290 SILAS DEANE HIGHWAY, SUITE 3C, WETHERSFIELD, CT, 061094337
MEDSERV OF CONNECTICUT, INC. SAVINGS PLAN 2015 061428595 2016-06-28 MEDSERV OF CONNECTICUT, INC. 3
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-09-01
Business code 621399
Sponsor’s telephone number 2036992400
Plan sponsor’s address HCMA/NHCMA, 1290 SILAS DEANE HIGHWAY, SUITE 3C, WETHERSFIELD, CT, 061094337

Signature of
Role Plan administrator
Date 2016-06-28
Name of individual signing FIORENTINO, RICHARD
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-06-28
Name of individual signing FIORENTINO, RICHARD
Valid signature Filed with authorized/valid electronic signature
MEDSERV OF CONNECTICUT, INC. SAVINGS PLAN 2014 061428595 2015-04-21 MEDSERV OF CONNECTICUT, INC. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-09-01
Business code 621399
Sponsor’s telephone number 2036992400
Plan sponsor’s address HCMA/NHCMA, 1290 SILAS DEANE HIGHWAY, SUITE 3C, WETHERSFIELD, CT, 061094337

Signature of
Role Plan administrator
Date 2015-04-21
Name of individual signing RICHARD FIORENTINO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-04-21
Name of individual signing RICHARD FIORENTINO
Valid signature Filed with authorized/valid electronic signature
MEDSERV OF CONNECTICUT, INC. SAVINGS PLAN 2013 061428595 2014-06-02 MEDSERV OF CONNECTICUT, INC. 4
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-09-01
Business code 621399
Sponsor’s telephone number 2036992400
Plan sponsor’s address HCMA/NHCMA, 55 REALITY DRIVE, SUITE 300, CHESHIRE, CT, 06410

Signature of
Role Plan administrator
Date 2014-06-02
Name of individual signing RICHARD FIORENTINO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-06-02
Name of individual signing RICHARD FIORENTINO
Valid signature Filed with authorized/valid electronic signature
MEDSERV OF CONNECTICUT, INC. SAVINGS PLAN 2012 061428595 2013-04-11 MEDSERV OF CONNECTICUT, INC. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-09-01
Business code 621399
Sponsor’s telephone number 2036992400
Plan sponsor’s address HCMA/NHCMA, 55 REALITY DRIVE, SUITE 300, CHESHIRE, CT, 06410

Signature of
Role Plan administrator
Date 2013-04-11
Name of individual signing RICHARD FIORENTINO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-04-11
Name of individual signing RICHARD FIORENTINO
Valid signature Filed with authorized/valid electronic signature
MEDSERV OF CONNECTICUT, INC. SAVINGS PLAN 2011 061428595 2012-05-06 MEDSERV OF CONNECTICUT, INC. 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-09-01
Business code 621399
Sponsor’s telephone number 2036992400
Plan sponsor’s address HCMA/NHCMA, 55 REALITY DRIVE, SUITE 300, CHESHIRE, CT, 06410

Plan administrator’s name and address
Administrator’s EIN 061428595
Plan administrator’s name MEDSERV OF CONNECTICUT, INC.
Plan administrator’s address HCMA/NHCMA, 55 REALITY DRIVE, SUITE 300, CHESHIRE, CT, 06410
Administrator’s telephone number 2036992400

Signature of
Role Plan administrator
Date 2012-05-06
Name of individual signing RICHARD FIORENTINO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-05-06
Name of individual signing RICHARD FIORENTINO
Valid signature Filed with authorized/valid electronic signature
MEDSERV OF CONNECTICUT, INC. SAVINGS PLAN 2010 061428595 2011-07-25 MEDSERV OF CONNECTICUT, INC. 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-09-01
Business code 621399
Sponsor’s telephone number 2036992400
Plan sponsor’s address HCMA/NHCMA, 55 REALITY DRIVE, SUITE 300, CHESHIRE, CT, 06410

Plan administrator’s name and address
Administrator’s EIN 061428595
Plan administrator’s name MEDSERV OF CONNECTICUT, INC.
Plan administrator’s address HCMA/NHCMA, 55 REALITY DRIVE, SUITE 300, CHESHIRE, CT, 06410
Administrator’s telephone number 2036992400

Signature of
Role Plan administrator
Date 2011-07-25
Name of individual signing RICHARD FIORENTINO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-25
Name of individual signing RICHARD FIORENTINO
Valid signature Filed with authorized/valid electronic signature
MEDSERV OF CONNECTICUT, INC. SAVINGS PLAN 2010 061428595 2011-07-24 MEDSERV OF CONNECTICUT, INC. 6
Three-digit plan number (PN) 002
Effective date of plan 1986-09-01
Business code 621399
Sponsor’s telephone number 2036992400
Plan sponsor’s address HCMA/NHCMA, 55 REALITY DRIVE, SUITE 300, CHESHIRE, CT, 06410

Plan administrator’s name and address
Administrator’s EIN 061428595
Plan administrator’s name MEDSERV OF CONNECTICUT, INC.
Plan administrator’s address HCMA/NHCMA, 55 REALITY DRIVE, SUITE 300, CHESHIRE, CT, 06410
Administrator’s telephone number 2036992400

Signature of
Role Plan administrator
Date 2011-07-24
Name of individual signing RICHARD FIORENTINO
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2011-07-24
Name of individual signing RICHARD FIORENTINO
Valid signature Filed with incorrect/unrecognized electronic signature
MEDSERV OF CONNECITCUT, INC. SAVINGS PLAN 2009 061428595 2010-10-04 MEDSERV OF CONNECTICUT, INC. 6
File View Page
Three-digit plan number (PN) 002
Effective date of plan 1986-09-01
Business code 621399
Sponsor’s telephone number 2036992400
Plan sponsor’s address HCMA/NHCMA, 55 REALITY DRIVE, SUITE 300, CHESHIRE, CT, 06410

Plan administrator’s name and address
Administrator’s EIN 061428595
Plan administrator’s name MEDSERV OF CONNECTICUT, INC.
Plan administrator’s address HCMA/NHCMA, 55 REALITY DRIVE, SUITE 300, CHESHIRE, CT, 06410
Administrator’s telephone number 2036992400

Signature of
Role Plan administrator
Date 2010-10-04
Name of individual signing RICHARD FIORENTINO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-04
Name of individual signing RICHARD FIORENTINO
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Business address Residence address
ROBERT G. SIEGEL Agent C/O DAY, BERRY & HOWARD, CITYPLACE, HARTFORD, CT, 06103, United States 138 BEACON HILL DR, WEST HARTFORD, CT, 06117, United States

Officer

Name Role Business address Residence address
BRIAN KEYES MD Officer CHILDRENS CENTER OF HAMDEN, 1400 WHITNEY AVENUE, HAMDEN, CT, 06517, United States 38 BARBERRY LANE, WOODBRIGE, CT, 06525, United States
SARIT M. PATEL Officer STARLING PHYSICIANS, ONE LAKE STREET, NEW BRITAIN, CT, 06052, United States 10 HINCHLEY WOOD, FARMINGTON, CT, 06032, United States

Filing

Filing number Filing date Effective date Filing category Filing type Report year
0005726543 2016-12-28 2016-12-31 Dissolution Certificate of Dissolution No data
0005720840 2016-12-19 No data Annual Report Annual Report 2015
0005720842 2016-12-19 No data Annual Report Annual Report 2016
0005126094 2014-06-16 No data Annual Report Annual Report 2014
0004928967 2013-08-21 No data Annual Report Annual Report 2013
0004628386 2012-05-16 No data Annual Report Annual Report 2012
0004579613 2011-06-14 No data Annual Report Annual Report 2011
0004238473 2010-07-08 No data Annual Report Annual Report 2010
0004002199 2009-07-30 No data Annual Report Annual Report 2009
0003689930 2008-05-30 No data Annual Report Annual Report 2008

Related by officers

ROBERT G. SIEGEL

MEDICAL DELIVERY SYSTEMS MSO, INC. ONE WAY REALTY, LLC TALCOTT CORPORATION ADOPT-A-SCHOOL OF BEAUFORT COUNTY, INC. CONSULTING OPHTHALMOLOGISTS OPTICAL, INC. TRIANGLE AVIATION LLC CONNECTICUT G.I. ENDOSCOPY CENTER, LLC TALCOTT II, LLC TALCOTT EQUITIES II LIMITED PARTNERSHIP TALCOTT II GOLD, LLC

Related by address

No related companies by address

Date of last update: 20 Jan 2025

Sources: Connecticut's Official State Website

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