Instrumentl eFile Render
Object ID: 202143189349100009 - Rendered 2024-05-03
TIN: 26-1437283
Form
990-PF
Department of the Treasury
Internal Revenue Service
Return of Private Foundation
or Section 4947(a)(1) Trust Treated as Private Foundation
Do not enter social security numbers on this form as it may be made public.
Go to
www.irs.gov/Form990PF
for instructions and the latest information.
OMB No. 1545-0052
20
20
Open to Public Inspection
For calendar year 2020, or tax year beginning
01-01-2020
, and ending
12-31-2020
Name of foundation
PFIZER PATIENT ASSISTANCE FOUNDATION INC
Number and street (or P.O. box number if mail is not delivered to street address)
235 EAST 42ND STREET
Room/suite
City or town, state or province, country, and ZIP or foreign postal code
NEW YORK
,
NY
10017
A Employer identification number
26-1437283
B
Telephone number (see instructions)
(212) 733-2323
C
If exemption application is pending, check here
G
Check all that apply:
Initial return
Initial return of a former public charity
Final return
Amended return
Address change
Name change
D 1.
Foreign organizations, check here.............
2
. Foreign organizations meeting the 85%
test, check here and attach computation ...
E
If private foundation status was terminated
under section 507(b)(1)(A), check here .......
H
Check type of organization:
Section 501(c)(3) exempt private foundation
Section 4947(a)(1) nonexempt charitable trust
Other taxable private foundation
F
If the foundation is in a 60-month termination
under section 507(b)(1)(B), check here .......
I
Fair market value of all assets at end
of year (from Part II, col. (c),
line 16)
$
27,444,554
J
Accounting method:
Cash
Accrual
Other (specify)
(Part I, column (d) must be on cash basis.)
Part I
Analysis of Revenue and Expenses
(The total of amounts in columns (b), (c), and (d) may not necessarily equal the amounts in column (a) (see instructions).)
(a)
Revenue and
expenses per
books
(b)
Net investment
income
(c)
Adjusted net
income
(d)
Disbursements
for charitable
purposes
(cash basis only)
1
Contributions, gifts, grants, etc., received (attach schedule)
1,419,759,439
2
Check
.............
3
Interest on savings and temporary cash investments
4
Dividends and interest from securities
...
5a
Gross rents
............
b
Net rental income or (loss)
6a
Net gain or (loss) from sale of assets not on line 10
b
Gross sales price for all assets on line 6a
7
Capital gain net income (from Part IV, line 2)
...
0
8
Net short-term capital gain
.........
0
9
Income modifications
...........
10a
Gross sales less returns and allowances
b
Less: Cost of goods sold
....
c
Gross profit or (loss) (attach schedule)
.....
11
Other income (attach schedule)
.......
12
Total.
Add lines 1 through 11
........
1,419,759,439
0
0
13
Compensation of officers, directors, trustees, etc.
0
0
0
0
14
Other employee salaries and wages
......
15
Pension plans, employee benefits
.......
16a
Legal fees (attach schedule)
.........
b
Accounting fees (attach schedule)
.......
c
Other professional fees (attach schedule)
....
27,762,398
0
0
27,764,199
17
Interest
...............
18
Taxes (attach schedule) (see instructions)
...
19
Depreciation (attach schedule) and depletion
...
20
Occupancy
..............
21
Travel, conferences, and meetings
.......
22
Printing and publications
..........
23
Other expenses (attach schedule)
.......
750
0
0
750
24
Total operating and administrative expenses.
Add lines 13 through 23
..........
27,763,148
0
0
27,764,949
25
Contributions, gifts, grants paid
.......
1,388,021,141
1,388,021,141
26
Total expenses and disbursements.
Add lines 24 and 25
1,415,784,289
0
0
1,415,786,090
27
Subtract line 26 from line 12:
a
Excess of revenue over expenses and disbursements
3,975,150
b
Net investment income
(if negative, enter -0-)
0
c
Adjusted net income
(if negative, enter -0-)
...
0
For Paperwork Reduction Act Notice, see instructions.
Cat. No. 11289X
Form
990-PF
(2020)
Form 990-PF (2020)
Page
2
Part II
Balance Sheets
Attached schedules and amounts in the description column
should be for end-of-year amounts only. (See instructions.)
Beginning of year
End of year
(a)
Book Value
(b)
Book Value
(c)
Fair Market Value
1
Cash—non-interest-bearing
.............
4,931,240
-204,046
-204,046
2
Savings and temporary cash investments
.........
3
Accounts receivable
Less: allowance for doubtful accounts
4
Pledges receivable
27,648,600
Less: allowance for doubtful accounts
20,410,303
27,648,600
27,648,600
5
Grants receivable
.................
6
Receivables due from officers, directors, trustees, and other
disqualified persons (attach schedule) (see instructions)
.....
7
Other notes and loans receivable (attach schedule)
Less: allowance for doubtful accounts
8
Inventories for sale or use
..............
9
Prepaid expenses and deferred charges
..........
10a
Investments—U.S. and state government obligations (attach schedule)
b
Investments—corporate stock (attach schedule)
.......
c
Investments—corporate bonds (attach schedule)
.......
11
Investments—land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
12
Investments—mortgage loans
.............
13
Investments—other (attach schedule)
..........
14
Land, buildings, and equipment: basis
Less: accumulated depreciation (attach schedule)
15
Other assets (describe
)
16
Total assets
(to be completed by all filers—see the
instructions. Also, see page 1, item I)
25,341,543
27,444,554
27,444,554
17
Accounts payable and accrued expenses
..........
13,947,518
12,075,379
18
Grants payable
.................
19
Deferred revenue
.................
20
Loans from officers, directors, trustees, and other disqualified persons
21
Mortgages and other notes payable (attach schedule)
......
22
Other liabilities (describe
)
23
Total liabilities
(add lines 17 through 22)
.........
13,947,518
12,075,379
Foundations that follow FASB ASC 958, check here
and complete lines 24, 25, 29 and 30.
24
Net assets without donor restrictions
...........
25
Net assets with donor restrictions
............
11,394,025
15,369,175
Foundations that do not follow FASB ASC 958, check here
and complete lines 26 through 30.
26
Capital stock, trust principal, or current funds
........
27
Paid-in or capital surplus, or land, bldg., and equipment fund
28
Retained earnings, accumulated income, endowment, or other funds
29
Total net assets or fund balances
(see instructions)
.....
11,394,025
15,369,175
30
Total liabilities and net assets/fund balances
(see instructions)
.
25,341,543
27,444,554
Part III
Analysis of Changes in Net Assets or Fund Balances
1
Total net assets or fund balances at beginning of year—Part II, column (a), line 29 (must agree with end-of-year figure reported on prior year’s return)
...............
1
11,394,025
2
Enter amount from Part I, line 27a
.....................
2
3,975,150
3
Other increases not included in line 2 (itemize)
3
0
4
Add lines 1, 2, and 3
..........................
4
15,369,175
5
Decreases not included in line 2 (itemize)
5
0
6
Total net assets or fund balances at end of year (line 4 minus line 5)—Part II, column (b), line 29
.
6
15,369,175
Form
990-PF
(2020)
Form 990-PF (2020)
Page
3
Part IV
Capital Gains and Losses for Tax on Investment Income
(a)
List and describe the kind(s) of property sold (e.g., real estate,
2-story brick warehouse; or common stock, 200 shs. MLC Co.)
(b)
How acquired
P—Purchase
D—Donation
(c)
Date acquired
(mo., day, yr.)
(d)
Date sold
(mo., day, yr.)
1a
b
c
d
e
(e)
Gross sales price
(f)
Depreciation allowed
(or allowable)
(g)
Cost or other basis
plus expense of sale
(h)
Gain or (loss)
(e) plus (f) minus (g)
a
b
c
d
e
Complete only for assets showing gain in column (h) and owned by the foundation on 12/31/69
(l)
Gains (Col. (h) gain minus
col. (k), but not less than -0-)
or
Losses (from col.(h))
(i)
F.M.V. as of 12/31/69
(j)
Adjusted basis
as of 12/31/69
(k)
Excess of col. (i)
over col. (j), if any
a
b
c
d
e
2
Capital gain net income or (net capital loss)
If gain, also enter in Part I, line 7
If (loss), enter -0- in Part I, line 7
2
3
Net short-term capital gain or (loss) as defined in sections 1222(5) and (6):
If gain, also enter in Part I, line 8, column (c) (see instructions). If (loss), enter -0-
in Part I, line 8
...................
3
Part V
Qualification Under Section 4940(e) for Reduced Tax on Net Investment Income
SECTION 4940(e) REPEALED ON DECEMBER 20, 2019 - DO NOT COMPLETE
1
Reserved
(a)
Reserved
(b)
Reserved
(c)
Reserved
(d)
Reserved
2
Reserved
...........................
2
3
Reserved
...........................
3
4
Reserved
...........................
4
5
Reserved
...........................
5
6
Reserved
...........................
6
7
Reserved
...........................
7
8
Reserved
,..........................
8
Form
990-PF
(2020)
Form 990-PF (2020)
Page
4
Part VI
Excise Tax Based on Investment Income (Section 4940(a), 4940(b), 4940(e), or 4948—see instructions)
1a
Exempt operating foundations described in section 4940(d)(2), check here
and enter “N/A" on line 1.
Date of ruling or determination letter:
(attach copy of letter if necessary–see instructions)
b
Reserved
................................
1
0
c
All other domestic foundations enter 1.39% of line 27b. Exempt foreign organizations enter 4% of Part I, line 12, col. (b)
2
Tax under section 511 (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
2
0
3
Add lines 1 and 2
...........................
3
0
4
Subtitle A (income) tax (domestic section 4947(a)(1) trusts and taxable foundations only. Others enter -0-)
4
0
5
Tax based on investment income.
Subtract line 4 from line 3. If zero or less, enter -0-
.....
5
0
6
Credits/Payments:
a
2020 estimated tax payments and 2019 overpayment credited to 2020
6a
0
b
Exempt foreign organizations—tax withheld at source
......
6b
0
c
Tax paid with application for extension of time to file (Form 8868)
...
6c
0
d
Backup withholding erroneously withheld
...........
6d
0
7
Total credits and payments. Add lines 6a through 6d
..............
7
0
8
Enter any
penalty
for underpayment of estimated tax.
Check here
if Form 2220 is attached.
8
0
9
Tax due.
If the total of lines 5 and 8 is more than line 7, enter
amount owed
.......
9
0
10
Overpayment.
If line 7 is more than the total of lines 5 and 8, enter the
amount overpaid
...
10
11
Enter the amount of line 10 to be:
Credited to 2021 estimated tax
Refunded
11
Part VII-A
Statements Regarding Activities
1a
During the tax year, did the foundation attempt to influence any national, state, or local legislation or did
Yes
No
it participate or intervene in any political campaign?
....................
1a
No
b
Did it spend more than $100 during the year (either directly or indirectly) for political purposes? See the instructions
for the definition
.................................
1b
No
If the answer is "Yes" to
1a
or
1b,
attach a detailed description of the activities and copies of any materials
published or distributed by the foundation in connection with the activities.
c
Did the foundation file
Form 1120-POL
for this year?
.....................
1c
No
d
Enter the amount (if any) of tax on political expenditures (section 4955) imposed during the year:
(1)
On the foundation.
$
0
(2)
On foundation managers.
$
0
e
Enter the reimbursement (if any) paid by the foundation during the year for political expenditure tax imposed
on foundation managers.
$
0
2
Has the foundation engaged in any activities that have not previously been reported to the IRS?
.......
2
No
If "Yes," attach a detailed description of the activities.
3
Has the foundation made any changes, not previously reported to the IRS, in its governing instrument, articles
of incorporation, or bylaws, or other similar instruments?
If "Yes," attach a conformed copy of the changes
....
3
No
4a
Did the foundation have unrelated business gross income of $1,000 or more during the year?
........
4a
No
b
If "Yes," has it filed a tax return on
Form 990-T
for this year?
...................
4b
5
Was there a liquidation, termination, dissolution, or substantial contraction during the year?
.........
5
No
If "Yes," attach the statement required by General Instruction T.
6
Are the requirements of section 508(e) (relating to sections 4941 through 4945) satisfied either:
By language in the governing instrument, or
By state legislation that effectively amends the governing instrument so that no mandatory directions
that conflict with the state law remain in the governing instrument?
................
6
Yes
7
Did the foundation have at least $5,000 in assets at any time during the year?
If "Yes," complete Part II, col. (c),
and Part XV.
.................................
7
Yes
8a
Enter the states to which the foundation reports or with which it is registered (see instructions)
DE
,
NY
b
If the answer is "Yes" to line 7, has the foundation furnished a copy of Form 990-PF to the Attorney
General (or designate) of each state as required by General Instruction G?
If "No," attach explanation
.
8b
Yes
9
Is the foundation claiming status as a private operating foundation within the meaning of section 4942(j)(3)
or 4942(j)(5) for calendar year 2020 or the taxable year beginning in 2020? See the instructions for Part XIV.
If "Yes," complete Part XIV
.............................
9
Yes
10
Did any persons become substantial contributors during the tax year?
If "Yes," attach a schedule listing their names
and addresses.
...............................
10
No
Form
990-PF
(2020)
Form 990-PF (2020)
Page
5
Part VII-A
Statements Regarding Activities
(continued)
11
At any time during the year, did the foundation, directly or indirectly, own a controlled entity within the
meaning of section 512(b)(13)? If "Yes," attach schedule. See instructions
.............
11
No
12
Did the foundation make a distribution to a donor advised fund over which the foundation or a disqualified person had
advisory privileges? If "Yes," attach statement. See instructions
.................
12
No
13
Did the foundation comply with the public inspection requirements for its annual returns and exemption application?
13
Yes
Website address
WWW.PFIZERRXPATHWAYS.COM
14
The books are in care of
NIESHA FOSTER
Telephone no.
(212) 733-0413
Located at
235 EAST 42ND STREET
NEW YORK
NY
ZIP+4
10017
15
Section 4947(a)(1) nonexempt charitable trusts filing Form 990-PF in lieu of
Form 1041
—check here
.........
and enter the amount of tax-exempt interest received or accrued during the year
........
15
16
At any time during calendar year 2020, did the foundation have an interest in or a signature or other authority over
Yes
No
a bank, securities, or other financial account in a foreign country?
.................
16
No
See the instructions for exceptions and filing requirements for FinCEN Form 114. If "Yes", enter the name of the foreign
country
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
File Form 4720 if any item is checked in the "Yes" column, unless an exception applies.
Yes
No
1a
During the year did the foundation (either directly or indirectly):
(1)
Engage in the sale or exchange, or leasing of property with a disqualified person?
Yes
No
(2)
Borrow money from, lend money to, or otherwise extend credit to (or accept it from)
a disqualified person?
......................
Yes
No
(3)
Furnish goods, services, or facilities to (or accept them from) a disqualified person?
Yes
No
(4)
Pay compensation to, or pay or reimburse the expenses of, a disqualified person?
Yes
No
(5)
Transfer any income or assets to a disqualified person (or make any of either available
for the benefit or use of a disqualified person)?
...............
Yes
No
(6)
Agree to pay money or property to a government official? (
Exception.
Check "No"
if the foundation agreed to make a grant to or to employ the official for a period
after termination of government service, if terminating within 90 days.)
.......
Yes
No
b
If any answer is "Yes" to 1a(1)–(6), did
any
of the acts fail to qualify under the exceptions described in Regulations
section 53.4941(d)-3 or in a current notice regarding disaster assistance? See instructions
........
1b
No
Organizations relying on a current notice regarding disaster assistance check here
........
c
Did the foundation engage in a prior year in any of the acts described in 1a, other than excepted acts,
that were not corrected before the first day of the tax year beginning in 2020?
.............
1c
No
2
Taxes on failure to distribute income (section 4942) (does not apply for years the foundation was a private
operating foundation defined in section 4942(j)(3) or 4942(j)(5)):
a
At the end of tax year 2020, did the foundation have any undistributed income (lines 6d
and 6e, Part XIII) for tax year(s) beginning before 2020?
.............
Yes
No
If "Yes," list the years
20
,
20
,
20
,
20
b
Are there any years listed in 2a for which the foundation is
not
applying the provisions of section 4942(a)(2)
(relating to incorrect valuation of assets) to the year’s undistributed income? (If applying section 4942(a)(2)
to
all
years listed, answer "No" and attach statement—see instructions.)
..............
2b
c
If the provisions of section 4942(a)(2) are being applied to
any
of the years listed in 2a, list the years here.
20
,
20
,
20
,
20
3a
Did the foundation hold more than a 2% direct or indirect interest in any business enterprise at
any time during the year?
......................
Yes
No
b
If "Yes," did it have excess business holdings in 2020 as a result of
(1)
any purchase by the foundation
or disqualified persons after May 26, 1969;
(2)
the lapse of the 5-year period (or longer period approved
by the Commissioner under section 4943(c)(7)) to dispose of holdings acquired by gift or bequest; or
(3)
the lapse of the 10-, 15-, or 20-year first phase holding period?
(Use Schedule C, Form 4720, to determine
if the foundation had excess business holdings in 2020.)
..................
3b
4a
Did the foundation invest during the year any amount in a manner that would jeopardize its charitable purposes?
4a
No
b
Did the foundation make any investment in a prior year (but after December 31, 1969) that could jeopardize its
charitable purpose that had not been removed from jeopardy before the first day of the tax year beginning in 2020?
4b
No
Form
990-PF
(2020)
Form 990-PF (2020)
Page
6
Part VII-B
Statements Regarding Activities for Which Form 4720 May Be Required
(continued)
5a
During the year did the foundation pay or incur any amount to:
Yes
No
(1)
Carry on propaganda, or otherwise attempt to influence legislation (section 4945(e))?
Yes
No
(2)
Influence the outcome of any specific public election (see section 4955); or to carry
on, directly or indirectly, any voter registration drive?
.............
Yes
No
(3)
Provide a grant to an individual for travel, study, or other similar purposes?
Yes
No
(4)
Provide a grant to an organization other than a charitable, etc., organization described
in section 4945(d)(4)(A)? See instructions
................
Yes
No
(5)
Provide for any purpose other than religious, charitable, scientific, literary, or
educational purposes, or for the prevention of cruelty to children or animals?
.....
Yes
No
b
If any answer is "Yes" to 5a(1)–(5), did
any
of the transactions fail to qualify under the exceptions described in
Regulations section 53.4945 or in a current notice regarding disaster assistance? See instructions
......
5b
Organizations relying on a current notice regarding disaster assistance check here
.........
c
If the answer is "Yes" to question 5a(4), does the foundation claim exemption from the
tax because it maintained expenditure responsibility for the grant?
..........
Yes
No
If "Yes," attach the statement required by Regulations section 53.4945–5(d).
6a
Did the foundation, during the year, receive any funds, directly or indirectly, to pay premiums on
a personal benefit contract?
.....................
Yes
No
b
Did the foundation, during the year, pay premiums, directly or indirectly, on a personal benefit contract?
....
6b
No
If "Yes" to 6b, file Form 8870.
7a
At any time during the tax year, was the foundation a party to a prohibited tax shelter transaction?
Yes
No
b
If "Yes", did the foundation receive any proceeds or have any net income attributable to the transaction?
....
7b
8
Is the foundation subject to the section 4960 tax on payment(s) of more than $1,000,000 in remuneration or
excess parachute payment during the year?
.................
Yes
No
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
1
List all officers, directors, trustees, foundation managers and their compensation. See instructions
(a)
Name and address
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(If not paid, enter
-0-)
(d)
Contributions to employee benefit plans and deferred compensation
(e)
Expense account,
other allowances
CAROLINE ROAN
CHAIRPERSON
5.00
0
0
0
235 EAST 42ND STREET
NEW YORK
,
NY
10017
NIESHA FOSTER
EXECUTIVE DIRECTOR
32.00
0
0
0
235 EAST 42ND STREET
NEW YORK
,
NY
10017
ANDREW CALLOS
DIRECTOR
1.00
0
0
0
235 EAST 42ND STREET
NEW YORK
,
NY
10017
PATRICK CAUBEL
DIRECTOR
1.00
0
0
0
235 EAST 42ND STREET
NEW YORK
,
NY
10017
DAVE HERING
DIRECTOR
1.00
0
0
0
235 EAST 42ND STREET
NEW YORK
,
NJ
10017
ROBERT JONES
DIRECTOR
1.00
0
0
0
235 EAST 42ND STREET
NEW YORK
,
NY
10017
BEATRIZ FARO
DIRECTOR
1.00
0
0
0
235 EAST 42ND STREET
NEW YORK
,
NY
10017
DEBBIE WALTERS
DIRECTOR
1.00
0
0
0
235 EAST 42ND STREET
NEW YORK
,
NY
10017
NICK LAGUNOWICH
DIRECTOR UNTIL 10/29/20
1.00
0
0
0
235 EAST 42ND STREET
NEW YORK
,
NY
10017
ANGELA LUKIN
DIRECTOR UNTIL 4/1/20
1.00
0
0
0
235 EAST 42ND STREET
NEW YORK
,
NY
10017
BERT BRUCE
DIRECTOR AS OF 10/29/20
1.00
0
0
0
235 EAST 42ND STREET
NEW YORK
,
PA
10017
DIEGO SACRISTAN
DIRECTOR AS OF 4/1/20
1.00
0
0
0
235 EAST 42ND STREET
NEW YORK
,
NY
10017
JAMES SAGE
DIRECTOR AS OF 10/29/20
1.00
0
0
0
235 EAST 42ND STREET
NEW YORK
,
NY
10017
JENNIFER WALTON
DIRECTOR AS OF 1/21
1.00
0
0
0
235 EAST 42ND STREET
NEW YORK
,
NY
10017
JENICA STROOCK
SECRETARY
21.00
0
0
0
100 ROUTE 206N
PEAPACK
,
NJ
07977
MICHAEL READING
TREASURER
1.00
0
0
0
235 EAST 42ND STREET
NEW YORK
,
NY
10017
2
Compensation of five highest-paid employees (other than those included on line 1—see instructions). If none, enter “NONE."
(a)
Name and address of each employee paid more than $50,000
(b)
Title, and average
hours per week
devoted to position
(c)
Compensation
(d)
Contributions to
employee benefit
plans and deferred
compensation
(e)
Expense account,
other allowances
NONE
Total
number of other employees paid over $50,000
...................
0
Form
990-PF
(2020)
Form 990-PF (2020)
Page
7
Part VIII
Information About Officers, Directors, Trustees, Foundation Managers, Highly Paid Employees,
and Contractors
(continued)
3
Five highest-paid independent contractors for professional services (see instructions). If none, enter "NONE".
(a)
Name and address of each person paid more than $50,000
(b)
Type of service
(c)
Compensation
SONEXUS HEALTH LLC
PROG ADMINISTRATION
11,573,869
2730 S EDMONDS LANE SUITE 300
LEWISVILLE
,
TX
75067
LASH GROUP
PROG ADMINISTRATION
8,321,226
1800 INNOVATION POINT
FORT MILL
,
SC
29715
CONDUENT COMMERCIAL SOLUTIONS LLC
PROG ADMINISTRATION
4,961,922
500 ATRIUM DRIVE
SOMERSET
,
NJ
08873
AMERIPHARMA INC
PROG ADMINISTRATION
1,902,936
2503 EAST 54TH STREET NORTH
SIOUX FALLS
,
SD
571045563
PRICEWATERHOUSE COOPERS LLCADVISORY
PROG ADMINISTRATION
411,948
PO BOX 905615
CHARLOTTE
,
NC
282905615
Total
number of others receiving over $50,000 for professional services
.............
0
Part IX-A
Summary of Direct Charitable Activities
List the foundation’s four largest direct charitable activities during the tax year. Include relevant statistical information such as the number of organizations and other beneficiaries served, conferences convened, research papers produced, etc.
Expenses
1
INDIVIDUAL PATIENT PROGRAMS
1,378,010,963
2
INSTITUTIONAL PATIENT ASSISTANCE PROGRAM
10,010,178
3
4
Part IX-B
Summary of Program-Related Investments
(see instructions)
Describe the two largest program-related investments made by the foundation during the tax year on lines 1 and 2.
Amount
1
2
All other program-related investments. See instructions.
3
Total.
Add lines 1 through 3
.........................
0
Form
990-PF
(2020)
Form 990-PF (2020)
Page
8
Part X
Minimum Investment Return
(All domestic foundations must complete this part. Foreign foundations, see instructions.)
1
Fair market value of assets not used (or held for use) directly in carrying out charitable, etc.,
purposes:
a
Average monthly fair market value of securities
...................
1a
0
b
Average of monthly cash balances
.......................
1b
0
c
Fair market value of all other assets (see instructions)
................
1c
0
d
Total
(add lines 1a, b, and c)
.........................
1d
0
e
Reduction claimed for blockage or other factors reported on lines 1a and
1c (attach detailed explanation)
.............
1e
0
2
Acquisition indebtedness applicable to line 1 assets
..................
2
0
3
Subtract line 2 from line 1d
.........................
3
0
4
Cash deemed held for charitable activities. Enter 1 1/2% of line 3 (for greater amount, see
instructions)
.............................
4
0
5
Net value of noncharitable-use assets.
Subtract line 4 from line 3. Enter here and on Part V, line 4
5
0
6
Minimum investment return.
Enter 5% of line 5
..................
6
0
Part XI
Distributable Amount
(see instructions) (Section 4942(j)(3) and (j)(5) private operating foundations and certain foreign organizations check here
and do not complete this part.)
1
Minimum investment return from Part X, line 6
....................
1
2a
Tax on investment income for 2020 from Part VI, line 5
......
2a
b
Income tax for 2020. (This does not include the tax from Part VI.)
...
2b
c
Add lines 2a and 2b
............................
2c
3
Distributable amount before adjustments. Subtract line 2c from line 1
............
3
4
Recoveries of amounts treated as qualifying distributions
................
4
5
Add lines 3 and 4
............................
5
6
Deduction from distributable amount (see instructions)
.................
6
7
Distributable amount
as adjusted. Subtract line 6 from line 5. Enter here and on Part XIII, line 1
...
7
Part XII
Qualifying Distributions
(see instructions)
1
Amounts paid (including administrative expenses) to accomplish charitable, etc., purposes:
a
Expenses, contributions, gifts, etc.—total from Part I, column (d), line 26
..........
1a
1,415,786,090
b
Program-related investments—total from Part IX-B
..................
1b
0
2
Amounts paid to acquire assets used (or held for use) directly in carrying out charitable, etc.,
purposes
...............................
2
3
Amounts set aside for specific charitable projects that satisfy the:
a
Suitability test (prior IRS approval required)
....................
3a
b
Cash distribution test (attach the required schedule)
.................
3b
4
Qualifying distributions.
Add lines 1a through 3b. Enter here and on Part V, line 8, and Part XIII, line 4
4
1,415,786,090
5
Foundations that qualify under section 4940(e) for the reduced rate of tax on net investment
income. Enter 1% of Part I, line 27b. See instructions
.................
5
0
6
Adjusted qualifying distributions.
Subtract line 5 from line 4
..............
6
1,415,786,090
Note:
The amount on line 6 will be used in Part V, column (b), in subsequent years when calculating whether the foundation qualifies for
the section 4940(e) reduction of tax in those years.
Form
990-PF
(2020)
Form 990-PF (2020)
Page
9
Part XIII
Undistributed Income
(see instructions)
(a)
Corpus
(b)
Years prior to 2019
(c)
2019
(d)
2020
1
Distributable amount for 2020 from Part XI, line 7
2
Undistributed income, if any, as of the end of 2020:
a
Enter amount for 2019 only
.......
b
Total for prior years:
20
,
20
,
20
3
Excess distributions carryover, if any, to 2020:
a
From 2015
......
b
From 2016
......
c
From 2017
......
d
From 2018
......
e
From 2019
......
f
Total
of lines 3a through e
........
4
Qualifying distributions for 2020 from Part
XII, line 4:
$
a
Applied to 2019, but not more than line 2a
b
Applied to undistributed income of prior years
(Election required—see instructions)
.....
c
Treated as distributions out of corpus (Election
required—see instructions)
........
d
Applied to 2020 distributable amount
.....
e
Remaining amount distributed out of corpus
5
Excess distributions carryover applied to 2020.
(If an amount appears in column (d), the
same amount must be shown in column (a).)
6
Enter the net total of each column as
indicated below:
a
Corpus. Add lines 3f, 4c, and 4e. Subtract line 5
b
Prior years’ undistributed income. Subtract
line 4b from line 2b
..........
c
Enter the amount of prior years’ undistributed
income for which a notice of deficiency has
been issued, or on which the section 4942(a)
tax has been previously assessed
......
d
Subtract line 6c from line 6b. Taxable amount
—see instructions
...........
e
Undistributed income for 2019. Subtract line
4a from line 2a. Taxable amount—see
instructions
.............
f
Undistributed income for 2020. Subtract
lines 4d and 5 from line 1. This amount must
be distributed in 2021
..........
7
Amounts treated as distributions out of
corpus to satisfy requirements imposed by
section 170(b)(1)(F) or 4942(g)(3) (Election may
be required - see instructions)
.......
8
Excess distributions carryover from 2015 not
applied on line 5 or line 7 (see instructions)
...
9
Excess distributions carryover to 2021.
Subtract lines 7 and 8 from line 6a
......
10
Analysis of line 9:
a
Excess from 2016
....
b
Excess from 2017
....
c
Excess from 2018
....
d
Excess from 2019
....
e
Excess from 2020
....
Form
990-PF
(2020)
Form 990-PF (2020)
Page
10
Part XIV
Private Operating Foundations
(see instructions and Part VII-A, question 9)
1a
If the foundation has received a ruling or determination letter that it is a private operating
foundation, and the ruling is effective for 2020, enter the date of the ruling
.......
2008-03-24
b
Check box to indicate whether the organization is a private operating foundation described in section
4942(j)(3)
or
4942(j)(5)
2a
Enter the lesser of the adjusted net
income from Part I or the minimum
investment return from Part X for each
year listed
..........
Tax year
Prior 3 years
(e) Total
(a)
2020
(b)
2019
(c)
2018
(d)
2017
0
0
0
0
0
b
85% of line 2a
.........
0
0
0
0
0
c
Qualifying distributions from Part XII,
line 4 for each year listed
.....
1,415,786,090
1,120,881,038
1,134,410,589
963,337,721
4,634,415,438
d
Amounts included in line 2c not used directly
for active conduct of exempt activities
..........
0
0
0
0
0
e
Qualifying distributions made directly
for active conduct of exempt activities.
Subtract line 2d from line 2c
....
1,415,786,090
1,120,881,038
1,134,410,589
963,337,721
4,634,415,438
3
Complete 3a, b, or c for the
alternative test relied upon:
a
“Assets" alternative test—enter:
(1)
Value of all assets
......
27,444,554
25,341,543
26,491,249
21,750,946
101,028,292
(2)
Value of assets qualifying
under section 4942(j)(3)(B)(i)
0
b
“Endowment" alternative test— enter 2/3
of minimum investment return shown in
Part X, line 6 for each year listed
...
0
c
“Support" alternative test—enter:
(1)
Total support other than gross
investment income (interest,
dividends, rents, payments
on securities loans (section
512(a)(5)), or royalties)
....
0
(2)
Support from general public
and 5 or more exempt
organizations as provided in
section 4942(j)(3)(B)(iii)
....
0
(3)
Largest amount of support
from an exempt organization
0
(4)
Gross investment income
0
Part XV
Supplementary Information (Complete this part only if the foundation had $5,000 or more in
assets at any time during the year—see instructions.)
1
Information Regarding Foundation Managers:
a
List any managers of the foundation who have contributed more than 2% of the total contributions received by the foundation
before the close of any tax year (but only if they have contributed more than $5,000). (See section 507(d)(2).)
b
List any managers of the foundation who own 10% or more of the stock of a corporation (or an equally large portion of the
ownership of a partnership or other entity) of which the foundation has a 10% or greater interest.
2
Information Regarding Contribution, Grant, Gift, Loan, Scholarship, etc., Programs:
Check here
if the foundation only makes contributions to preselected charitable organizations and does not accept
unsolicited requests for funds. If the foundation makes gifts, grants, etc. to individuals or organizations under
other conditions, complete items 2a, b, c, and d. See instructions
a
The name, address, and telephone number or email address of the person to whom applications should be addressed:
b
The form in which applications should be submitted and information and materials they should include:
c
Any submission deadlines:
d
Any restrictions or limitations on awards, such as by geographical areas, charitable fields, kinds of institutions, or other
factors:
Form
990-PF
(2020)
Form 990-PF (2020)
Page
11
Part XV
Supplementary Information
(continued)
3 Grants and Contributions Paid During the Year or Approved for Future Payment
Recipient
If recipient is an individual,
show any relationship to
any foundation manager
or substantial contributor
Foundation
status of
recipient
Purpose of grant or
contribution
Amount
Name and address (home or business)
a
Paid during the year
CENTRAL TEXAS COMMUNITY HEALTH CENTERS DBA COMMUNITYCARE
2901 MONTOPOLIS DR
AUSTIN
,
TX
78741
PC
CHARITABLE
691,216
HEART OF TEXAS COMMUNITY HEALTH CENTER
1600 PROVIDENCE DRIVE
WACO
,
TX
767072261
PC
CHARITABLE
114,912
NORTH CENTRAL TEXAS COMMUNITY
200 MLK JR BLVD PO BOX 720
WICHITA FALLS
,
TX
76301
PC
CHARITABLE
90,040
NORTHEAST ALABAMA HEALTH SERVICES
309 TAYLOR STREET
SCOTTSBORO
,
AL
35768
PC
CHARITABLE
75,086
GATEWAY COMMUNITY HEALTH CENTER
1515 PAPPAS ST PO BOX 3397
LAREDO
,
TX
78041
PC
CHARITABLE
60,063
CENTRO DE SALUD FAMILIAR LA FE
700 S OCHOA ST
EL PASO
,
TX
79901
PC
CHARITABLE
57,854
GATEWAY COMMUNITY HEALTH CENTER
1515 PAPPAS ST PO BOX 3397
LAREDO
,
TX
78041
PC
CHARITABLE
54,655
GFHS - DAVIDSON MEDICAL MINISTRIES
420 NORTH SALISBURY STREET
LEXINGTON
,
NC
27293
PC
CHARITABLE
54,504
COMMUNITY HEALTH CENTER OF SE KANSAS
3011 NORTH MICHIGAN STREET
PITTSBURG
,
KS
66762
PC
CHARITABLE
52,796
FORT BEND FAMILY HEALTH CENTER DBA ACCESS HEALTH
400 AUSTIN STREET
RICHMOND
,
TX
77469
PC
CHARITABLE
52,536
FAMILY ORIENTED PRIMARY HC MOBILE COUNT
251 N BAYOU ST PO BOX 2867
MOBILE
,
AL
36652
PC
CHARITABLE
51,039
SAMUEL U RODGERS COMMUNITY HEALTH CENTER
825 EUCLID AVE
KANSAS CITY
,
MO
64124
PC
CHARITABLE
47,323
NHFHS-2-NEW HORIZON PENDELTON
975 WEST FARIS ROAD
GREENVILLE
,
SC
29605
PC
CHARITABLE
46,117
KINTEGRA FAMILY MEDICINE - HIGHLAND
609 N HIGHLAND ST
GASTONIA
,
NC
28052
PC
CHARITABLE
45,016
KINTEGRA FAMILY MEDICINE - HUDSON
991 WEST HUDSON BLVD
GASTONIA
,
NC
28052
PC
CHARITABLE
43,712
EAST TEXAS COMMUNITY HEALTH SERVICES
1309 SOUTH UNIVERSITY DRIVE
NACOGDOCHES
,
TX
75961
PC
CHARITABLE
43,264
LITTLE RIVER MEDICAL CENTER 2
4220 CAROLINA EXCHANGE DRIVE
MYRTLE BEACH
,
SC
29579
PC
CHARITABLE
40,735
KINTEGRA FAMILY MEDICINE - STATESVILLE
1022 SHELTON AVENUE
STATESVILLE
,
NC
28677
PC
CHARITABLE
40,398
FRANKLIN MEMORIAL PRIMARY HEALTH CENTER
1303 DR MLK JR AVE PO BOX 2048
MOBILE
,
AL
36652
PC
CHARITABLE
39,630
KINTEGRA FAMILY MEDICINE - LINCOLNTON
212 GAMBLE DR
LINCOLNTON
,
NC
28092
PC
CHARITABLE
37,864
WASATCH HOMELESS HEALTH CARE4TH STREET CLINIC
409W 400S
SALT LAKE CITY
,
UT
84101
PC
CHARITABLE
37,312
UNITED MEDICAL CENTER #3
913 SOUTH MAIN STREET
DEL RIO
,
TX
78840
PC
CHARITABLE
33,157
EL FRANCO LEE PHARMACY
8901 BOONE ROAD
HOUSTON
,
TX
77099
PC
CHARITABLE
32,191
PEOPLE'S PHARMACY
6630 DE MOSS STREET
HOUSTON
,
TX
77074
PC
CHARITABLE
30,900
CURTIS V COOPER PRIMARY HEALTH CENTER
106 E BROAD ST PO BOX 2024
SAVANNAH
,
GA
31401
PC
CHARITABLE
29,057
STRAWBERRY PHARMACY
927 E SHAW ROAD
PASADENA
,
TX
77506
PC
CHARITABLE
26,104
KINTEGRA ADULT & PEDIATRIC MEDICINE - X-RAY DR
2721 XRAY DRIVE
GASTONIA
,
NC
28052
PC
CHARITABLE
25,990
ACRES HOME PHARMACY
818 RINGOLD STREET
HOUSTON
,
TX
77088
PC
CHARITABLE
25,815
HEALTH SERVICES
1845 CHERRY ST
MONTGOMERY
,
AL
36107
PC
CHARITABLE
25,684
MARY MAHONEY MEMORIAL HEALTH CENTER
12716 NE 36TH PO BOX 30589
OKLAHOMA CITY
,
OK
73140
PC
CHARITABLE
24,074
CARESTL HEALTH #1
5471 DR ML KING DR
ST LOUIS
,
MO
63112
PC
CHARITABLE
23,207
CAROLINA FAMILY HC'S -2-HARVEST
8282 SOUTH NC 58 HWY
ELM CITY
,
NC
27822
PC
CHARITABLE
22,295
NORTHWEST PHARMACY
1100 WEST 34TH STREET
HOUSTON
,
TX
77018
PC
CHARITABLE
21,664
MIAMI BEACH COMMUNITY HEALTH CENTER 4
11645 BISCAYNE BLVD SUITE 102
NORTH MIAMI
,
FL
33181
PC
CHARITABLE
21,107
CAROLINA FAMILY HCS -1- WILSON
303 GREEN STREET E
WILSON
,
NC
27893
PC
CHARITABLE
21,050
BROWARD HEALTH SPECIALTY CARE
1111 WEST BROWARD BOULEVARD
FT LAUDERDLE
,
FL
33312
PC
CHARITABLE
20,801
GREATER MERIDIAN HEALTH CLINIC INC
2701 DAVIS STREET
MERIDIAN
,
MS
39301
PC
CHARITABLE
19,927
MLK PHARMACY
3525 SWINGLE ROAD
HOUSTON
,
TX
77047
PC
CHARITABLE
19,072
LITTLE RIVER MEDICAL CENTER INC
PO BOX 547 ATTN KRIS CHIPLINSKI
4303 LIVE OAK DR
LITTER RIVER
,
SC
29566
PC
CHARITABLE
18,978
SANTA BARBARA COUNTY HEALTH CARE SRVS
300 N SAN ANTONIO RD
SANTA BARBARA
,
CA
931101316
PC
CHARITABLE
17,607
ALDINE PHARMACY
4755 ALDINE MAIL ROUTE
HOUSTON
,
TX
77039
PC
CHARITABLE
17,421
RURAL HEALTH CARE INC DBA AZALEA HEALTH - DAYTONA BEACH
1425 DUNN AVE
DAYTONA BEACH
,
FL
32114
PC
CHARITABLE
17,138
NORTH CENTRAL FAMILY MEDICAL CENTER
1131 SALUDA STREET
ROCK HILL
,
SC
29730
PC
CHARITABLE
16,883
RURAL HEALTH CARE INC DBA KEYSTONE HEIGHTS FAMILY HEALTH CENTER
100 COMMERCIAL DRIVE
KEYSTONE HEIGHTS
,
FL
32656
PC
CHARITABLE
16,841
GULFFATE PHARMACY
7550 OFFICE CITY DRIVE
HOUSTON
,
TX
77012
PC
CHARITABLE
15,858
FONDREN FOUNDATION LAB AT SMITH SMITH PHARMACY
2525-A HOLLY HALL STREET
HOUSTON
,
TX
77054
PC
CHARITABLE
15,778
CASA DE AMIGOS PHARMACY
1615 NORTH MAIN STREET
HOUSTON
,
TX
77009
PC
CHARITABLE
15,613
E A SQUATTY LYONS PHARMACY
1712 FIRST STREET SUITE M20
HUMBLE
,
TX
77338
PC
CHARITABLE
15,111
RURAL HEALTH CARE INC DBA AZALEA HEALTH - PALM COAST
460 PALM COAST PKWY SW STE 5
PALM COAST
,
FL
32137
PC
CHARITABLE
14,772
CENTRAL NORTH ALABAMA HEALTH SERVICES
751 PLEASANT ROW PO BOX 18488
HUNTSVILLE
,
AL
35804
PC
CHARITABLE
14,739
CLINICAS DEL CAMINO REAL INC-VENTURA
200 S WELLS RD ROOM 1 PHARMACY
VENTURA
,
CA
93004
PC
CHARITABLE
14,570
QUALITY OF LIFE-1-GADSDEN
1411 PIEDMONT CUT-OFF PO BOX 97
GADSDEN
,
AL
35903
PC
CHARITABLE
14,425
MORTON COMPREHENSIVE HEALTH SERVICES
1334 N LANSING AVE
TULSA
,
OK
741065907
PC
CHARITABLE
13,805
RURAL HEALTH CARE INC DBA AZALEA HEALTH - ST AUGUSTINE
105 WHITEHALL DR SUITE 109-114
ST AUGUSTINE
,
FL
32086
PC
CHARITABLE
13,422
MIAMI BEACH COMMUNITY HEALTH CENTER
710 ALTON ROAD
MIAMI BEACH
,
FL
33139
PC
CHARITABLE
12,367
NUESTRA CLINICA DEL VALLE-4-MISSION
611 N BRYAN RD
MISSION
,
TX
78572
PC
CHARITABLE
11,949
PHARMACY OF PALMETTO HEALTH COUNCIL INC
643 MAIN STREET
PALMETTO
,
GA
30268
PC
CHARITABLE
11,689
MCPN-8-NORTH AURORA FAMILY HEALTH SERVICES
3292 PEORIA STREET
AURORA
,
CO
80010
PC
CHARITABLE
11,509
RURAL HEALTH CARE INC
1213 HWY 20 PO BOX 190
INTERLACHEN
,
FL
32148
PC
CHARITABLE
11,424
BALTIMORE MEDICAL SYSTEM INC AT HIGHLANDTOWN
3505 EASTERN AVE
BALTIMORE
,
MD
21224
PC
CHARITABLE
11,191
BAYTOWN PHARMACY
1602 GARTH ROAD
BAYTOWN
,
TX
77520
PC
CHARITABLE
11,147
NHFHS-4-TRAVELERS REST
1588 GEER HWY
TRAVELERS REST
,
SC
29690
PC
CHARITABLE
11,017
MCR HEALTH INC
919 53RD AVENUE EAST
BRADENTON
,
FL
34203
PC
CHARITABLE
10,934
UNITED MEDICAL CENTERS #1
2525 N VETERANS BLVD PO BOX 1470
EAGLE PASS
,
TX
78852
PC
CHARITABLE
10,357
QUALITY OF LIFE-3-ANNISTON
1316 NOBLE STREET SUITE 1-C
ANNISTON
,
AL
36201
PC
CHARITABLE
10,312
COLLIER HEALTH SERVICES INC
1454 MADISON AVENUE
IMMOKALEE
,
FL
34142
PC
CHARITABLE
10,284
NUESTRA CLINICA DEL VALLE -1-SAN JUAN
801 WEST FIRST STREET
SAN JUAN
,
TX
78589
PC
CHARITABLE
9,350
SETTEGAST PHARMACY
9105 NORTH WAYSIDE DRIVE
HOUSTON
,
TX
77028
PC
CHARITABLE
9,112
TANDEM HEALTH SC
1278 NORTH LAFAYETTE DRIVE
SUMTER
,
SC
29150
PC
CHARITABLE
8,542
RURAL HEALTH CARE INC DBA AZALEA HEALTH - GREEN COVE
1305 N ORANGE AVE SUITE 120-123
GREEN COVE SPRINGS
,
FL
32043
PC
CHARITABLE
8,272
PHSI-8-CHAPEL HILL COMMUNITY HEALTH CENTER PHARMACY
107 CONNER DR STE 100
CHAPEL HILL
,
NC
27514
PC
CHARITABLE
8,183
PHSI- 6- SILER CITY CHC
224 SOUTH 10TH AVENUE
SILER CITY
,
NC
27344
PC
CHARITABLE
7,950
TECHE ACTION CLINIC
1115 WEBER STREET
FRANKLIN
,
LA
70538
PC
CHARITABLE
7,826
PHSI-1-CARRBORO HEALTH CENTER
301 LLOYD STREET
CARRBORO
,
NC
27510
PC
CHARITABLE
7,765
BROWARD HOSP-CORA E BRAYNON FAMILY HEALTH CENTER
200 NORTHWEST 7TH AVE
FT LAUDERDALE
,
FL
33311
PC
CHARITABLE
7,005
CAROLINA FAMILY HC'S -3- FREEDOM HILL
162 NC HWY 33 EAST
TARBORO
,
NC
27886
PC
CHARITABLE
6,546
COASTAL FAMILY HEALTH CENTER INC
9113 HWY 49 SUITE 200
GULFPORT
,
MS
39503
PC
CHARITABLE
6,360
CENTRO SAN VICENTE
8061 ALAMEDA AVE
EL PASO
,
TX
79915
PC
CHARITABLE
6,328
QUALITY OF LIFE-5- HEFLIN
64 GILES STREET
HEFLIN
,
AL
36264
PC
CHARITABLE
5,616
HEALTH MINISTRIES CLINIC PHARMACY
720 MEDICAL CENTER DR
NEWTON
,
KS
67114
PC
CHARITABLE
5,450
MEDNORTH HEALTH CENTER
925 NORTH 4TH ST
WILMINGTON
,
NC
28401
PC
CHARITABLE
5,066
PHSI-3-PROSPECT HILL
140 MAIN STREET
PROSPECT HILL
,
NC
27314
PC
CHARITABLE
4,996
COMMUNITY HEALTH AND SOCIAL SERVICES
5635 WEST FORT
DETROIT
,
MI
48209
PC
CHARITABLE
4,667
MOSES LAKE COMMUNITY HC
605 COOLIDGE DRIVE
MOSES LAKE
,
WA
98837
PC
CHARITABLE
4,505
FAMILY HEALTHCARE PHARMACY SOUTH
4025 9TH AVE SOUTH
FARGO
,
ND
58103
PC
CHARITABLE
4,138
FAMILY HEALTH CENTER
2215 PORTLAND AVENUE
LOUISVILLE
,
KY
40212
PC
CHARITABLE
3,899
LOS BARRIOS UNIDOS COMMUNITY CLINICINC
809 SINGLETON BLVD
DALLAS
,
TX
75212
PC
CHARITABLE
3,857
POMPANO ADULT PRIMARY HEALTH CENTER
2011 NW 3RD AVE
POMPANO BEACH
,
FL
330604800
PC
CHARITABLE
3,778
SWOPE PARKWAY HEALTH CENTER
3801 BLUE PARKWAY
KANSAS CITY
,
MO
64130
PC
CHARITABLE
3,740
THOMAS STREET PHARMACY
2015 THOMAS STREET
HOUSTON
,
TX
77009
PC
CHARITABLE
3,255
SANDHILLS MEDICAL FOUNDATION #2
425 N SALEM AVE
SUMTER
,
SC
29150
PC
CHARITABLE
2,892
SANDHILLS MEDICAL FOUNDATION
40 BALDWIN AVE
LUGOFF
,
SC
29078
PC
CHARITABLE
2,844
HEALTHSOURCE OF OHIO
5400 DUPONT CIRCLE SUITE A
MILFORD
,
OH
451502793
PC
CHARITABLE
2,787
CLINICA MONSENOR OSCAR A ROMERO
123 SOUTH ALVARADO ST
LOS ANGELES
,
CA
90057
PC
CHARITABLE
2,747
CHARITABLE PHARMACY OF NORTH TEXAS INC DBA ST VINCENT DEPAUL PHARMACY
5750 PINELAND DR SUITE 280
DALLAS
,
TX
75231
PC
CHARITABLE
2,390
PHSI-4-CHARLES DREW
221 N GRAHAM-HOPEDALE
BURLINGTON
,
NC
27215
PC
CHARITABLE
2,285
NHFHS-3-GREER
111-A BERRY AVENUE
GREER
,
SC
29651
PC
CHARITABLE
2,214
NUESTRA CLINICA DEL VALLE-3-MERCEDES
801 WEST FIRST STREET
SAN JUAN
,
TX
78589
PC
CHARITABLE
2,165
GFHN-2-ST JAMES HEALTH CENTER
55 E JULIAN ST
SAN JOSE
,
CA
95112
PC
CHARITABLE
2,038
CFFHC DBA TRUE HEALTH - HOFFNER
5449 SOUTH SEMORAN SUITE 14
ORLANDO
,
FL
32822
PC
CHARITABLE
1,580
COMMUNITY HEALTH CENTER INC- FORREST CITY
7900 FOREST CITY ROAD
ORLANDO
,
FL
32810
PC
CHARITABLE
1,580
PHSI-2-HAYWOOD-MONCURE HC
7228 PITTSBORO - MONCURE RD
MONCURE
,
NC
27559
PC
CHARITABLE
1,563
COMMWELL HEALTH OF NEWTON GROVE SPIVEYS CORNER
3331 EASY STREET
DUNN
,
NC
28334
PC
CHARITABLE
1,352
BEN ARCHER HEALTH CENTER -1-LAS CRUCES
1600 THORPE ROAD
LAS CRUCES
,
NM
88012
PC
CHARITABLE
1,264
CHC-3-SOUTHLAKE FAMILY HEALTH CENTER
12696 WEST BROAD STREET
GROVELAND
,
FL
34736
PC
CHARITABLE
1,264
PHSI-7-BURLINGTON CHC PHARMACY
1214 VAUGHN RD SUITE 104
BURLINGTON
,
NC
27217
PC
CHARITABLE
1,043
COMMUNITY HEALTH CENTERS - LEESBURG
225 N FIRST ST
LEESBURG
,
FL
34748
PC
CHARITABLE
948
CHC-5-PINE HILLS FAMILY HC
840 MERCY DRIVE
ORLANDO
,
FL
32808
PC
CHARITABLE
948
MBCHC-2- BEVERLY PRESS CENTER
1221-71ST STREET
MIAMI BEACH
,
FL
33141
PC
CHARITABLE
789
RURAL HEALTH CARE INC
1302 RIVER ST
PALATKA
,
FL
32177
PC
CHARITABLE
746
CHC-1-WINTER GARDEN FAMILY HC
13275 WEST COLONIAL DRIVE
WINTER GARDEN
,
FL
347873984
PC
CHARITABLE
632
CHC-2-APOPKA FAMILY HEALTH
225 EAST SEVENTH STREET
APOPKA
,
FL
32703
PC
CHARITABLE
632
MULTNOMAH COUNTYNORTHEAST
426 SW STARK ST 9TH FL
PORTLAND
,
OR
97204
PC
CHARITABLE
444
FAMILY HEALTH CARE CENTER
301 N P AVENUE NORTH
FARGO
,
ND
58102
PC
CHARITABLE
430
GFHN-6-GARDNER SOUTH COUNTY HEALTH CENTER
7526 MONTEREY ST
GILROY
,
CA
95020
PC
CHARITABLE
327
COASTAL FAMILY HEALTH CENTERS
1025 DIVISION ST SUITE A
BILOXI
,
MS
39530
PC
CHARITABLE
316
BREWER MEDICAL CENTER
735 WILSON ST
BREWER
,
ME
04412
PC
CHARITABLE
316
ANCHORAGE NEIGHBORHOOD HEALTH CENTER
4951 BUSINESS PARK BLVD STE 106
ANCHORAGE
,
AK
99503
PC
CHARITABLE
136
MULTNOMAH COUNTYEAST COUNTY HEALTH SERV
426 SW STARK ST 9TH FLOOR
PORTLAND
,
OR
97204
PC
CHARITABLE
86
ROBERTA WATTS MEDICAL CENTER
1020 TUSCALOOSA AVE
GADSDEN
,
AL
35901
PC
CHARITABLE
68
TRUMAN MEDICAL CENTER
2301 HOLMES STREET PHARMACY DEPT
KANSAS CITY
,
MO
64108
PC
CHARITABLE
745,229
SHANDS JACKSONVILLE
655 WEST 8TH ST
JACKSONVILLE
,
FL
32209
PC
CHARITABLE
606,454
JPS HEALTH NETWORK
1500 S MAIN ST
FORT WORTH
,
TX
76104
PC
CHARITABLE
347,738
UNIVERSITY HEALTH CENTER-DOWNTOWN
527 N LEONA ST
SAN ANTONIO
,
TX
78207
PC
CHARITABLE
266,393
JACKSON MEMORIAL HOSPITAL
901 NW 17TH ST STE N ATTNLISA
STANFORD PHARM SRVS
MIAMI
,
FL
33136
PC
CHARITABLE
242,310
TRUMAN MEDICAL CENTER LAKEWOOD
7900 LEES SUMMIT ROAD
KANSAS CITY
,
MO
64139
PC
CHARITABLE
225,378
GRADY MEMORIAL HOSPITAL
80 JESSE HILL JR DR
ATLANTA
,
GA
30303
PC
CHARITABLE
167,216
UNIVERSITY MEDICAL CENTER OF EL PASO
4815 ALAMEDA AVE OUTPATIENT PHARM
DEPT 728
EL PASO
,
TX
79905
PC
CHARITABLE
104,272
UNIVERSITY OF NORTH CAROLINA HOSPITALS
4400 EMPEROR BLVD SUITE 200
DURHAM
,
NC
27703
PC
CHARITABLE
86,131
UNIVERSITY MEDICAL CENTER
602 INDIANA AVE
LUBBOCK
,
TX
79415
PC
CHARITABLE
83,989
MEMORIAL REGIONAL HOSPITAL PRIMARY CARE CENTERS
4105 PEMBROKE ROAD
HOLLYWOOD
,
FL
33021
PC
CHARITABLE
48,780
CMC-MYERS PARK PHARMACY
1350 SOUTH KINGS DRIVE
CHARLOTTE
,
NC
28207
PC
CHARITABLE
29,182
LSUHCSD-WO MOSS REGIONAL MEDICAL CTR
1000 WALTERS ST
LAKE CHARLES
,
LA
70607
PC
CHARITABLE
28,965
ATRIUM HEALTH PHARMACY BIDDLE POINT
1801 ROZZELLES FERRY ROAD
CHARLOTTE
,
NC
28208
PC
CHARITABLE
26,671
CMC-NORTHPARK PHARMACY
251 EASTWAY DRIVE
CHARLOTTE
,
NC
28213
PC
CHARITABLE
18,930
MEDICAL COLLEGE OF VA HOSPITAL
1250 E MARSHALL ST
RICHMOND
,
VA
23298
PC
CHARITABLE
16,922
METROHEALTH SYSTEM
2500 METRO HEALTH DR
CLEVELAND
,
OH
44109
PC
CHARITABLE
13,234
QUEENS HOSPITAL CENTER OUTPATIENT PHARMACY
82-68 164TH ST
JAMAICA
,
NY
11432
PC
CHARITABLE
8,640
MEMORIAL REGIONAL HOSPITAL
3501 JOHNSON STREET
HOLLYWOOD
,
FL
33021
PC
CHARITABLE
8,504
LBJ HOSPITAL OUTPATIENT PHARMACY
5656 KELLEY STREET
HOUSTON
,
TX
77026
PC
CHARITABLE
6,443
ESKENAZI HEALTH
720 ESKENAZI AVE ATTN PAM POWELL /
PHARM
INDIANAPOLIS
,
IN
46202
PC
CHARITABLE
4,807
CHRISTUS CABRINI INCARNATE WORD COMMUNITY PHARMACY
3000 S MACARTHUR DRIVE ATTN
PHARMACY
ALEXANDRIA
,
LA
71301
PC
CHARITABLE
3,137
UNIVERSITY OF VIRGINIA HEALTH SYSTEM
1215 LEE ST PO BOX 800674
CHARLOTTESVILLE
,
VA
22908
PC
CHARITABLE
1,769
UNIVERSITY NEW MEXICO HEALTH SCIENCE
1209 UNIVERSITY BLVD NE
ALBUQUERQUE
,
NM
87102
PC
CHARITABLE
168
MERCI CLINIC INC
1315 TATUM DRIVE
NEW BERN
,
NC
28560
PC
CHARITABLE
218,156
THE FREE MEDICAL CLINIC
1875 HARDEN ST
COLUMBIA
,
SC
29204
PC
CHARITABLE
186,851
COMMUNITYHEALTH MEDACCESS CHICAGO
2611 WEST CHICAGO AVENUE
CHICAGO
,
IL
60622
PC
CHARITABLE
183,245
CROSSOVER HEALTH MINISTRY
108 COWARDIN AVE
RICHMOND
,
VA
23224
PC
CHARITABLE
167,311
GREENVILLE FREE MEDICAL CLINIC
600 ARLINGTON AVE
GREENVILLE
,
SC
29601
PC
CHARITABLE
97,891
ARLINGTON FREE CLINIC
2921 SOUTH 11TH STREET
ARLINGTON
,
VA
22204
PC
CHARITABLE
53,250
BROCK HUGHES FREE CLINIC
450 WEST MONROE STREET
WYTHEVILLE
,
VA
24382
PC
CHARITABLE
50,127
LLOYD F MOSS FREE CLINIC
1301 SAM PERRY BLVD SUITE 100
FREDERICKSBURG
,
VA
22401
PC
CHARITABLE
49,221
CAPE FEAR CLINIC INC
1607 DOCTORS CIRCLE
WILMINGTON
,
NC
28401
PC
CHARITABLE
46,973
HEALTH AND HOPE CLINIC INC
1718 EAST OLIVE RD
PENSACOLA
,
FL
32514
PC
CHARITABLE
37,264
LACKEY FREE FAMILY MEDICINE CLINIC
1620 OLD WILLIAMSBURG ROAD
YORKTOWN
,
VA
23690
PC
CHARITABLE
26,178
WESTERN TIDEWATER FREE CLINIC
2019 MEADE PARKWAY
SUFFOLK
,
VA
23434
PC
CHARITABLE
25,931
ST VINCENT DEPAUL DBA VIRGINIA B ANDES COMMUNITY PHARMACY
21297 OLEAN BLVD UNIT B
PORT CHARLOTTE
,
FL
33952
PC
CHARITABLE
25,265
NORTHERN NECK FREE CLINIC
51 WILLIAM B GRAHAM COURT
KILMARNOCK
,
VA
22482
PC
CHARITABLE
16,425
COMMUNITY FREE CLINIC OF NEWPORT NEWS
727 25TH STREET
NEWPORT NEWS
,
VA
23607
PC
CHARITABLE
8,765
FREE CLINIC OF CULPEPER
610 LAUREL STREET SUITE 3
CULPEPER
,
VA
22701
PC
CHARITABLE
3,554
ANDERSON FREE CLINIC
414 NORTH FANT STREET
ANDERSON
,
SC
29621
PC
CHARITABLE
2,607
BRADLEY FREE CLINIC
1240 THIRD STREET SW
ROANOKE
,
VA
24016
PC
CHARITABLE
2,584
NOVASCRIPTS CENTRAL
6400 ARLINGTON BLVD
FALLS CHURCH
,
VA
22042
PC
CHARITABLE
2,553
FREE CLINIC OF FRANKLIN COUNTY
1171 FRANKLIN ST
ROCKY MOUNT
,
VA
24151
PC
CHARITABLE
2,528
MOUNTAIN CARE CENTER
8252 RIVERSIDE DRIVE
OAKWOOD
,
VA
24631
PC
CHARITABLE
1,349
WELVISTA
121 GREYSTONE BOULEVARD
COLUMBIA
,
SC
29210
PC
CHARITABLE
1,841,225
NC MEDASSIST
4428 TAGGART CREEK RD STE 101
CHARLOTTE
,
NC
28208
PC
CHARITABLE
983,796
CENLA MEDICATION ACCESS PROGRAM (CMAP)
1101 4TH ST STE 203B
ALEXANDRIA
,
LA
71301
PC
CHARITABLE
95,663
ST VINCENT DE PAUL CHARITABLE PHARMACY
1125 BANK ST
CINCINNATI
,
OH
45214
PC
CHARITABLE
13,462
ST VINCENT DE PAUL CHARITABLE PHARMACY - GLENHILLS
3015 GLENHILLS WAY
CINCINNATI
,
OH
45238
PC
CHARITABLE
3,837
GOOD SAMARITAN
2502 N TAMIAMI TRAIL
NOKOMIS
,
FL
34275
PC
CHARITABLE
1,982
BEACON CHARITABLE PHARMACY
408 9TH ST SW
CANTON
,
OH
44707
PC
CHARITABLE
582
INDIVIDUAL PATIENT PROGRAMS
235 EAST 42ND STREET
NEW YORK
,
NY
10017
PC
CHARITABLE
1,378,010,964
Total
.................................
3a
1,388,021,141
b
Approved for future payment
Total
.................................
3b
0
Form
990-PF
(2020)
Form 990-PF (2020)
Page
12
Part XVI-A
Analysis of Income-Producing Activities
Enter gross amounts unless otherwise indicated.
Unrelated business income
Excluded by section 512, 513, or 514
(e)
Related or exempt
function income
(See instructions.)
1
Program service revenue:
(a)
Business code
(b)
Amount
(c)
Exclusion code
(d)
Amount
a
b
c
d
e
f
g
Fees and contracts from government agencies
2
Membership dues and assessments
....
3
Interest on savings and temporary cash
investments
...........
4
Dividends and interest from securities
....
5
Net rental income or (loss) from real estate:
a
Debt-financed property
......
b
Not debt-financed property
.....
6
Net rental income or (loss) from personal property
7
Other investment income
.....
8
Gain or (loss) from sales of assets other than
inventory
............
9
Net income or (loss) from special events:
10
Gross profit or (loss) from sales of inventory
11
Other revenue:
a
b
c
d
e
12
Subtotal. Add columns (b), (d), and (e)
..
0
0
0
13
Total.
Add line 12, columns (b), (d), and (e)
..................
13
0
(See worksheet in line 13 instructions to verify calculations.)
Part XVI-B
Relationship of Activities to the Accomplishment of Exempt Purposes
Line No.
Explain below how each activity for which income is reported in column (e) of Part XVI-A contributed importantly to
the accomplishment of the foundation’s exempt purposes (other than by providing funds for such purposes). (See
instructions.)
Form
990-PF
(2020)
Form 990-PF (2020)
Page
13
Part XVII
Information Regarding Transfers To and Transactions and Relationships With Noncharitable Exempt Organizations
1
Did the organization directly or indirectly engage in any of the following with any other organization described in section 501(c) (other than section 501(c)(3) organizations) or in section 527, relating to political organizations?
Yes
No
a
Transfers from the reporting foundation to a noncharitable exempt organization of:
(1)
Cash
...................................
1a(1)
No
(2)
Other assets
.................................
1a(2)
No
b
Other transactions:
(1)
Sales of assets to a noncharitable exempt organization
....................
1b(1)
No
(2)
Purchases of assets from a noncharitable exempt organization
..................
1b(2)
No
(3)
Rental of facilities, equipment, or other assets
.......................
1b(3)
No
(4)
Reimbursement arrangements
...........................
1b(4)
No
(5)
Loans or loan guarantees
.............................
1b(5)
No
(6)
Performance of services or membership or fundraising solicitations
................
1b(6)
No
c
Sharing of facilities, equipment, mailing lists, other assets, or paid employees
..............
1c
No
d
If the answer to any of the above is "Yes," complete the following schedule. Column
(b)
should always show the fair market value
of the goods, other assets, or services given by the reporting foundation. If the foundation received less than fair market value
in any transaction or sharing arrangement, show in column
(d)
the value of the goods, other assets, or services received.
(a)
Line No.
(b)
Amount involved
(c)
Name of noncharitable exempt organization
(d)
Description of transfers, transactions, and sharing arrangements
2a
Is the foundation directly or indirectly affiliated with, or related to, one or more tax-exempt organizations
described in section 501(c) (other than section 501(c)(3)) or in section 527?
...........
Yes
No
b
If "Yes," complete the following schedule.
(a)
Name of organization
(b)
Type of organization
(c)
Description of relationship
Sign Here
Under penalties of perjury, I declare that I have examined this return, including accompanying schedules and statements, and to the best of my knowledge and belief, it is true, correct, and complete. Declaration of preparer (other than taxpayer) is based on all information of which preparer has any knowledge.
May the IRS discuss this return
with the preparer shown below?
See instructions.
Yes
No
Signature of officer or trustee
Date
Title
Paid Preparer Use Only
Print/Type preparer's name
Preparer's Signature
Date
Check if self-
employed
PTIN
Firm's name
Firm's EIN
Firm's address
Phone no.
Form
990-PF
(2020)
Additional Data
Software ID:
Software Version:
Form 990PF - Special Condition Description:
Special Condition Description