Form Health Associates (Ma), P.C.

Ct Corporation System Registered Agent	155 FEDERAL ST STE 700, BOSTON, MA 02110
Nam Kim M.D. President
Nam Kim M.D. Director
Nam Kim M.D. Secretary
Nam Kim M.D. TREASURER

179 LINCOLN ST STE 404, BOSTON, MA 02111 View Map

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Form 5500

179 Lincoln ST STE 400, Boston, Ma 02111 (617) 505-1520 EIN:85-1560074 Plan Admin:Guideline, Inc.

Year	Plan Name	Participants BOY/EOY	Assets BOY/EOY
2022	Plan NameFORM HEALTH ASSOCIATES (MA), P.C. 401(K) PLAN Plan #001 Participants BOY/EOY8 / 22 Assets BOY/EOY$22,499 / $280,148	2022	FORM HEALTH ASSOCIATES (MA), P.C. 401(K) PLAN - Plan #001	8 / 22	$22,499 / $280,148
2021	Plan NameFORM HEALTH ASSOCIATES (MA), P.C. 401(K) PLAN Plan #001 Participants BOY/EOY0 / 8 Assets BOY/EOY$0 / $22,499	2021	FORM HEALTH ASSOCIATES (MA), P.C. 401(K) PLAN - Plan #001	0 / 8	$0 / $22,499

Benefit & Retirement Plans based on Form 5500.

Address Match:179 Lincoln St Ste 404 Boston, MA

Healthy Life Physicians Group Pacific Northwest, P.C. Registered in West Virginia	Boston, MA Charleston, WV	View Report
Form Health Associates (Ma), P.C. Registered in Virginia	Boston, MA	View Report
Form Health Associates (Ma), P.C. Registered in Washington	Boston, MA Olympia, WA	View Report
Form Health Associates (Ma), P.C. Registered in Tennessee	Boston, MA Knoxville, TN	View Report
Form Health Associates (Ma), P.C. Inc. Registered in Florida	Boston, MA	View Report
Healthy Life Physicians Group Pacific Northwest. P.C. Inc. Registered in Utah	Boston, MA Midvale, UT	View Report
Healthy Life Physicians Group Pacific Northwest, P.C. Registered in Idaho	Boise, ID Boston, MA	View Report
Form Health Associates (Ma), P.C. Registered in New Hampshire	Boston, MA Concord, NH	View Report
Form Health Associates (Ma), P.C. Registered in Colorado	Centennial, CO Boston, MA	View Report
Healthy Life Physicians Group Pacific Northwest, P.C. Registered in Mississippi	Boston, MA Flowood, MS	View Report
Quilt Insurance Agency, LLC Registered in Virginia	Alexandria, VA Boston, MA	View Report
Form Health Associates (Ma), P.C. Registered in Mississippi	Boston, MA	View Report
Quilt Insurance Agency, LLC Registered in Alabama	Boston, MA Montgomery, AL	View Report
Quilt Insurance Agency, LLC Registered in Texas	Boston, MA	View Report

Address Match:179 Lincoln St Boston, MA

Form Health Associates (Ma), P.C. Registered in Vermont	Boston, MA Jeffersonville, VT	View Report
Fsg, Inc. Registered in Vermont	Boston, MA Jeffersonville, VT	View Report
First Wind Energy, LLC Registered in Colorado	Boston, MA Littleton, CO	View Report
First Wind O&M Facilities Management, LLC Registered in California	Boston, MA	View Report
First Wind California Holdings, LLC Registered in California	Boston, MA	View Report
Baseline Power, LLC Registered in Oregon	Boston, MA	View Report
Baseline Wind, LLC. Registered in Oregon	Boston, MA	View Report
Crazy Fork Wind, LLC Registered in Oregon	Boston, MA	View Report
First Wind Parts Supply, LLC Registered in Vermont	Barre, VT Boston, MA	View Report
Oregon Wind II, LLC Registered in Oregon	Boston, MA	View Report
Poplar Winds, LLC Registered in Oregon	Boston, MA	View Report
Provender, Inc. Registered in Florida	Boston, MA	View Report
Sun Mill Power, LLC Registered in Oregon	Boston, MA	View Report
First Wind Energy, LLC Registered in North Dakota	Bismarck, ND Boston, MA	View Report
First Wind Energy, LLC Registered in Idaho	Boston, MA	View Report
Murphy Flat Power, LLC Registered in Idaho	Boston, MA	View Report
Indigo Winds, LLC Registered in California	Boston, MA	View Report
North Country Wind, LLC Registered in New Hampshire	Boston, MA	View Report

The following government agencies have contributed data:

Secretary of the Commonwealth of Massachusetts U.S. Department of Labor

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