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  5. MOUNTAIN COMPREHENSIVE HEALTH CORPORATION

MOUNTAIN COMPREHENSIVE HEALTH CORPORATION

Company Details

Name: MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Jurisdiction: Kentucky
Profit or Non-Profit: Non-profit
Legal type: Kentucky Corporation
Status: Active
Standing: Good
File Date: 14 Mar 1972 (53 years ago)
Organization Date: 14 Mar 1972 (53 years ago)
Last Annual Report: 28 Feb 2024 (a year ago)
Organization Number: 0036886
Industry: Health Services
Number of Employees: Large (100+)
ZIP code: 41858
Primary County: Letcher
Principal Office: 10 E. MAIN ST, P.O. BOX 40 , WHITESBURG, KY 41858
Place of Formation: KENTUCKY

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
NKXAYGT53N34 2024-10-30 10 E MAIN ST, WHITESBURG, KY, 41858, 7346, USA PO BOX 40, WHITESBURG, KY, 41858, 0040, USA

Business Information
URL www.mchcky.com
Congressional District 05
State/Country of Incorporation KY, USA
Activation Date 2023-11-17
Initial Registration Date 2004-03-25
Entity Start Date 1972-03-14
Fiscal Year End Close Date Mar 31

Service Classifications
NAICS Codes 456130, 456199, 621112, 621210, 621310, 621320, 621498
Product and Service Codes M1DB, Q201, Q301, Q401, Q402, Q403, Q503, Q506, Q507, Q509, Q512, Q516, Q517, Q519, Q520, Q521, Q522, Q526, Q601, Q602, Q603, Q801, Q802, Q901

Points of Contacts
Electronic Business
Title PRIMARY POC
Name TERESA DOTSON, MBA
Role DIRECTOR OF FINANCIAL AFFAIRS
Address PO BOX 40, WHITESBURG, KY, 41858, USA
Title ALTERNATE POC
Name PHILLIP HAMPTON
Role COO
Address PO BOX 40, WHITESBURG, KY, 41858, 0040, USA
Government Business
Title PRIMARY POC
Name CHRIS BATES
Role CCO
Address PO BOX 40, WHITESBURG, KY, 41858, USA
Title ALTERNATE POC
Name JENNIFER HURT
Role GRANTS MANAGEMENT/ACCOUNTANT
Address 10 E MAIN ST, PO BOX 40, WHITESBURG, KY, 41858, USA
Past Performance
Title PRIMARY POC
Name MARY BACK
Address PO BOX 40, WHITESBURG, KY, 41858, 0040, USA
Title ALTERNATE POC
Name PHILLIP HAMPTON
Role COO
Address PO BOX 40, WHITESBURG, KY, 41858, 0040, USA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CRITICAL ILLNESS PLAN 2016 610712406 2018-10-04 MOUNTAIN COMPREHENSIVE HEALTH CORPORATION 141
File View Page
Three-digit plan number (PN) 515
Effective date of plan 2013-05-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LN, WHITESBURG, KY, 418587425
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LN, WHITESBURG, KY, 418587425

Number of participants as of the end of the plan year
Active participants 0
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0

Signature of
Role Plan administrator
Date 2018-10-04
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
PREPAID DENTAL CARE PLAN 2016 610712406 2018-10-04 MOUNTAIN COMPREHENSIVE HEALTH CORPORATION 420
File View Page
Three-digit plan number (PN) 512
Effective date of plan 2003-06-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858

Number of participants as of the end of the plan year
Active participants 0
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0

Signature of
Role Plan administrator
Date 2018-10-04
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN COMPREHENSIVE HEALTH CORPORATION 2016 610712406 2018-10-04 MOUNTAIN COMPREHENSIVE HEALTH CORPORATION 165
File View Page
Three-digit plan number (PN) 504
Effective date of plan 1978-09-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address 226 MEDICAL PLAZA LN, WHITESBURG, KY, 418587425
Plan sponsor’s address 226 MEDICAL PLAZA LN, WHITESBURG, KY, 418587425

Number of participants as of the end of the plan year
Active participants 0
Retired or separated participants receiving benefits 0
Other retired or separated participants entitled to future benefits 0
Deceased participants whose beneficiaries are receiving or are entitled to receive benefits 0

Signature of
Role Plan administrator
Date 2018-10-04
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN COMPREHENSIVE HEALTH CORPORATION 2016 610712406 2018-03-30 MOUNTAIN COMPREHENSIVE HEALTH CORPORATION 165
Three-digit plan number (PN) 504
Effective date of plan 1978-09-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address 226 MEDICAL PLAZA LN, WHITESBURG, KY, 418587425
Plan sponsor’s address 226 MEDICAL PLAZA LN, WHITESBURG, KY, 418587425

Number of participants as of the end of the plan year
Active participants 188

Signature of
Role Plan administrator
Date 2018-03-30
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
CRITICAL ILLNESS PLAN 2016 610712406 2017-06-27 MOUNTAIN COMPREHENSIVE HEALTH CORPORATION 141
Three-digit plan number (PN) 515
Effective date of plan 2013-05-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LN, WHITESBURG, KY, 418587425
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LN, WHITESBURG, KY, 418587425

Number of participants as of the end of the plan year
Active participants 206

Signature of
Role Plan administrator
Date 2017-06-27
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
PREPAID DENTAL CARE PLAN 2016 610712406 2017-12-11 MOUNTAIN COMPREHENSIVE HEALTH CORPORATION 420
Three-digit plan number (PN) 512
Effective date of plan 2003-06-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858

Number of participants as of the end of the plan year
Active participants 463

Signature of
Role Plan administrator
Date 2017-12-11
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
CRITICAL ILLNESS PLAN 2015 610712406 2016-12-02 MOUNTAIN COMPREHENSIVE HEALTH CORPORATION 0
File View Page
Three-digit plan number (PN) 515
Effective date of plan 2013-05-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LN, WHITESBURG, KY, 418587425
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LN, WHITESBURG, KY, 418587425

Number of participants as of the end of the plan year
Active participants 141

Signature of
Role Plan administrator
Date 2016-12-02
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN COMPREHENSIVE HEALTH CORPORATION 2015 610712406 2017-03-03 MOUNTAIN COMPREHENSIVE HEALTH CORPORATION 130
File View Page
Three-digit plan number (PN) 504
Effective date of plan 1978-09-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Plan sponsor’s address 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858

Number of participants as of the end of the plan year
Active participants 165

Signature of
Role Plan administrator
Date 2017-03-03
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
MOUNTAIN COMPREHENSIVE HEALTH CORPORATION 2014 610712406 2016-02-16 MOUNTAIN COMPREHENSIVE HEALTH CORPORATION 123
File View Page
Three-digit plan number (PN) 504
Effective date of plan 1978-09-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Plan sponsor’s address 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858

Plan administrator’s name and address
Administrator’s EIN 610712406
Plan administrator’s name MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Plan administrator’s address 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Administrator’s telephone number 6066334823

Number of participants as of the end of the plan year
Active participants 130

Signature of
Role Plan administrator
Date 2016-02-16
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
MCHC HEALTH INSURANCE PLAN 2014 610712406 2016-02-12 MOUNTAIN COMPREHENSIVE HEALTH CORPORATION 140
File View Page
Three-digit plan number (PN) 511
Effective date of plan 1997-12-10
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address 226 MEDICAL PLAZA LANE, PO BOX 40, WHITESBURG, KY, 41858
Plan sponsor’s address 226 MEDICAL PLAZA LANE, PO BOX 40, WHITESBURG, KY, 41858

Plan administrator’s name and address
Administrator’s EIN 610712406
Plan administrator’s name MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Plan administrator’s address 226 MEDICAL PLAZA LANE, PO BOX 40, WHITESBURG, KY, 41858
Administrator’s telephone number 6066334823

Number of participants as of the end of the plan year
Active participants 164

Signature of
Role Plan administrator
Date 2016-02-12
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/12/03/20151203094908P030101022071001.pdf
Three-digit plan number (PN) 515
Effective date of plan 2013-05-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LANE, WHIESBURG, KY, 41858
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHIESBURG, KY, 41858

Number of participants as of the end of the plan year
Active participants 142

Signature of
Role Plan administrator
Date 2015-12-03
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/11/09/20151109080704P030076412775001.pdf
Three-digit plan number (PN) 512
Effective date of plan 2003-06-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858

Number of participants as of the end of the plan year
Active participants 357

Signature of
Role Plan administrator
Date 2015-11-09
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/06/22/20150622131610P030018489661001.pdf
Three-digit plan number (PN) 511
Effective date of plan 1997-12-10
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address 226 MEDICAL PLAZA LANE, PO BOX 40, WHITESBURG, KY, 41858
Plan sponsor’s address 226 MEDICAL PLAZA LANE, PO BOX 40, WHITESBURG, KY, 41858

Plan administrator’s name and address
Administrator’s EIN 610712406
Plan administrator’s name MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Plan administrator’s address 226 MEDICAL PLAZA LANE, PO BOX 40, WHITESBURG, KY, 41858
Administrator’s telephone number 6066334823

Number of participants as of the end of the plan year
Active participants 140

Signature of
Role Plan administrator
Date 2015-06-15
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/10/10/20141010092821P040016766653001.pdf
Three-digit plan number (PN) 504
Effective date of plan 1978-09-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Plan sponsor’s address 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858

Number of participants as of the end of the plan year
Active participants 123

Signature of
Role Plan administrator
Date 2014-10-10
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/10/10/20141010083520P030042148951001.pdf
Three-digit plan number (PN) 512
Effective date of plan 2003-06-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858

Number of participants as of the end of the plan year
Active participants 199

Signature of
Role Plan administrator
Date 2014-10-10
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/10/10/20141010083452P040016698045001.pdf
Three-digit plan number (PN) 515
Effective date of plan 2013-05-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858

Number of participants as of the end of the plan year
Active participants 119

Signature of
Role Plan administrator
Date 2014-10-10
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/12/31/20131231063611P040148421603001.pdf
Three-digit plan number (PN) 512
Effective date of plan 2003-06-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858

Number of participants as of the end of the plan year
Active participants 196

Signature of
Role Plan administrator
Date 2013-12-30
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/01/28/20140128133830P040217490993001.pdf
Three-digit plan number (PN) 504
Effective date of plan 1978-09-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address 226 MEDICAL PLAZA LANE, PO BOX 40, WHITESBURG, KY, 41858
Plan sponsor’s address 226 MEDICAL PLAZA LANE, PO BOX 40, WHITESBURG, KY, 41858

Number of participants as of the end of the plan year
Active participants 122

Signature of
Role Plan administrator
Date 2014-01-28
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/01/28/20140128133756P030188086211001.pdf
Three-digit plan number (PN) 511
Effective date of plan 1997-12-10
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address 226 MEDICAL PLAZA LANE, PO BOX 40, WHITESBURG, KY, 41858
Plan sponsor’s address 226 MEDICAL PLAZA LANE, PO BOX 40, WHITESBURG, KY, 41858

Number of participants as of the end of the plan year
Active participants 142

Signature of
Role Plan administrator
Date 2014-01-28
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/01/28/20140128133637P040189005939001.pdf
Three-digit plan number (PN) 514
Effective date of plan 2009-07-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address 226 MEDICAL PLAZA LANE, PO BOX 40, WHITESBURG, KY, 41858
Plan sponsor’s address 226 MEDICAL PLAZA LANE, PO BOX 40, WHITESBURG, KY, 41858

Number of participants as of the end of the plan year
Active participants 203

Signature of
Role Plan administrator
Date 2014-01-28
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/02/08/20130208072819P040028450149001.pdf
Three-digit plan number (PN) 514
Effective date of plan 2009-07-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address 226 MEDICAL PLAZA LANE, PO BOX 40, WHITESBURG, KY, 41858
Plan sponsor’s address 226 MEDICAL PLAZA LANE, PO BOX 40, WHITESBURG, KY, 41858

Plan administrator’s name and address
Administrator’s EIN 610712406
Plan administrator’s name MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Plan administrator’s address 226 MEDICAL PLAZA LANE, PO BOX 40, WHITESBURG, KY, 41858
Administrator’s telephone number 6066334823

Number of participants as of the end of the plan year
Active participants 214

Signature of
Role Plan administrator
Date 2013-02-08
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/02/08/20130208134233P040028769957001.pdf
Three-digit plan number (PN) 504
Effective date of plan 1978-09-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858

Plan administrator’s name and address
Administrator’s EIN 610712406
Plan administrator’s name MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Plan administrator’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Administrator’s telephone number 6066334823

Number of participants as of the end of the plan year
Active participants 120

Signature of
Role Plan administrator
Date 2013-02-08
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/02/08/20130208134220P030110500721001.pdf
Three-digit plan number (PN) 511
Effective date of plan 1997-12-10
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858

Plan administrator’s name and address
Administrator’s EIN 610712406
Plan administrator’s name MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Plan administrator’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Administrator’s telephone number 6066334823

Number of participants as of the end of the plan year
Active participants 135

Signature of
Role Plan administrator
Date 2013-02-08
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/09/20/20120920070858P030006561348001.pdf
Three-digit plan number (PN) 512
Effective date of plan 2003-06-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858

Plan administrator’s name and address
Administrator’s EIN 610712406
Plan administrator’s name MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Plan administrator’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Administrator’s telephone number 6066334823

Number of participants as of the end of the plan year
Active participants 198

Signature of
Role Plan administrator
Date 2012-09-19
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/04/11/20120411112352P030301877456001.pdf
Three-digit plan number (PN) 511
Effective date of plan 1997-12-10
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858

Plan administrator’s name and address
Administrator’s EIN 610712406
Plan administrator’s name MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Plan administrator’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Administrator’s telephone number 6066334823

Number of participants as of the end of the plan year
Active participants 150

Signature of
Role Plan administrator
Date 2012-04-09
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/01/19/20120119103011P040002888386001.pdf
Three-digit plan number (PN) 514
Effective date of plan 2008-07-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858

Plan administrator’s name and address
Administrator’s EIN 610712406
Plan administrator’s name MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Plan administrator’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Administrator’s telephone number 6066334823

Number of participants as of the end of the plan year
Active participants 221

Signature of
Role Plan administrator
Date 2011-11-01
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/10/26/20111026110812P040160236225001.pdf
Three-digit plan number (PN) 514
Effective date of plan 2009-07-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858

Plan administrator’s name and address
Administrator’s EIN 610712406
Plan administrator’s name MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Plan administrator’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Administrator’s telephone number 6066334823

Number of participants as of the end of the plan year
Active participants 215

Signature of
Role Plan administrator
Date 2011-10-26
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/10/26/20111026110751P040719683328001.pdf
Three-digit plan number (PN) 504
Effective date of plan 1978-09-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858

Plan administrator’s name and address
Administrator’s EIN 610712406
Plan administrator’s name MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Plan administrator’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Administrator’s telephone number 6066334823

Number of participants as of the end of the plan year
Active participants 139

Signature of
Role Plan administrator
Date 2011-10-26
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 514
Effective date of plan 2009-07-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858

Plan administrator’s name and address
Administrator’s EIN 610712406
Plan administrator’s name MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Plan administrator’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Administrator’s telephone number 6066334823

Number of participants as of the end of the plan year
Active participants 215

Signature of
Role Plan administrator
Date 2011-09-15
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/09/16/20110916110735P030611861024001.pdf
Three-digit plan number (PN) 512
Effective date of plan 2003-06-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858

Plan administrator’s name and address
Administrator’s EIN 610712406
Plan administrator’s name MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Plan administrator’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Administrator’s telephone number 6066334823

Number of participants as of the end of the plan year
Active participants 207

Signature of
Role Plan administrator
Date 2011-09-16
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/09/16/20110916110620P030131224641001.pdf
Three-digit plan number (PN) 512
Effective date of plan 2003-06-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858

Plan administrator’s name and address
Administrator’s EIN 610712406
Plan administrator’s name MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Plan administrator’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Administrator’s telephone number 6066334823

Number of participants as of the end of the plan year
Active participants 223

Signature of
Role Plan administrator
Date 2011-09-16
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/09/16/20110916091457P040606297904001.pdf
Three-digit plan number (PN) 511
Effective date of plan 1997-12-10
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858

Plan administrator’s name and address
Administrator’s EIN 610712406
Plan administrator’s name MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Plan administrator’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Administrator’s telephone number 6066334823

Number of participants as of the end of the plan year
Active participants 158

Signature of
Role Plan administrator
Date 2011-09-16
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/09/16/20110916091432P030131171537001.pdf
Three-digit plan number (PN) 504
Effective date of plan 1978-09-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226, MEDICAL PLAZA LANE, KY, 41858
Plan sponsor’s address PO BOX 40, 226, MEDICAL PLAZA LANE, KY, 41858

Plan administrator’s name and address
Administrator’s EIN 610712406
Plan administrator’s name MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Plan administrator’s address PO BOX 40, 226, MEDICAL PLAZA LANE, KY, 41858
Administrator’s telephone number 6066334823

Number of participants as of the end of the plan year
Active participants 139

Signature of
Role Plan administrator
Date 2011-09-16
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/09/16/20110916110657P040606530272001.pdf
Three-digit plan number (PN) 512
Effective date of plan 2003-06-01
Business code 621111
Sponsor’s telephone number 6066334823
Plan sponsor’s mailing address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Plan sponsor’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858

Plan administrator’s name and address
Administrator’s EIN 610712406
Plan administrator’s name MOUNTAIN COMPREHENSIVE HEALTH CORPORATION
Plan administrator’s address PO BOX 40, 226 MEDICAL PLAZA LANE, WHITESBURG, KY, 41858
Administrator’s telephone number 6066334823

Number of participants as of the end of the plan year
Active participants 214

Signature of
Role Plan administrator
Date 2011-09-16
Name of individual signing TERESA FLEMING
Valid signature Filed with authorized/valid electronic signature

Director

Name Role
PHYLLIS INGRAM Director
T. M. MANNS Director
JOHN R. HOSKINS Director
HENRY S. CAMPBELL Director
PAUL PRATT Director
CATHIE DAY Director
STEPHEN T ADAMS Director
IVAL FINNEY Director
MARSHAL JARNEGAN Director

Incorporator

Name Role
T. M. MANNS Incorporator
HENRY S. CAMPBELL Incorporator
JOHN R. HOSKINS Incorporator
IVAL FINNEY Incorporator
MARSHALL JARNIGAN Incorporator

Registered Agent

Name Role
L. M. CAUDILL (ATT. AT LAW) Registered Agent

Officer

Name Role
L.M. (MIKE) CAUDILL Officer

Former Company Names

Name Action
MOUNTAIN COMPREHENSIVE HEALTH, INCORPORATED Old Name

Assumed Names

Name Status Expiration Date
LEATHERWOOD PHARMACY Active 2029-03-14
WHITESBURG PHARMACY Active 2029-03-14
HARLAN PHARMACY Active 2029-03-14
HINDMAN CLINIC Active 2028-11-10
HINDMAN DENTAL CLINIC Active 2028-11-08
MCHC KNOTT COUNTY PHARMACY Active 2028-08-23
KNOTT COUNTY PHARMACY Active 2028-08-23
PULMONARY REHABILITATION CLINIC Active 2028-07-18
RCEK PULMONARY REHAB Active 2028-07-18
MCHC PULMONARY REHAB Active 2028-07-18

Filings

Name File Date
Certificate of Assumed Name 2024-03-14
Certificate of Assumed Name 2024-03-14
Certificate of Assumed Name 2024-03-14
Annual Report 2024-02-28
Registered Agent name/address change 2024-02-28
Certificate of Assumed Name 2023-11-10
Certificate of Assumed Name 2023-11-08
Principal Office Address Change 2023-11-02
Certificate of Assumed Name 2023-08-23
Certificate of Assumed Name 2023-08-23

Related by officers

PHYLLIS INGRAM

MOUNTAIN COMPREHENSIVE SPECIALTY SERVICES, INC.

T. M. MANNS

KNOTT COUNTY WATER ASSOCIATION, INC. KNOTT COUNTY PROPERTY OWNERS PROTECTIVE ASSOCIATION, INCORPORATED KNOTT COUNTY HANDCRAFT, INC. REED BRANCH COAL COMPANY, INCORPORATED

JOHN R. HOSKINS

STINNETT COMMUNITY ACTION COUNCIL, INCORPORATED

MARSHALL JARNIGAN

BACKWOODS DAY CARE CENTER, INCORPORATED BACKWOODS COMMUNITY C A C CENTER, INC. KENTUCKY RIVER HEALTH FACILITIES DEVELOPMENT CORPORATION APPALACHIANS FOR BETTER CARE, INC.

PAUL PRATT

MOUNTAIN COMPREHENSIVE SPECIALTY SERVICES, INC.

CATHIE DAY

MOUNTAIN COMPREHENSIVE SPECIALTY SERVICES, INC.

STEPHEN T ADAMS

AUSTIN COAL, INC. MOUNTAIN COMPREHENSIVE SPECIALTY SERVICES, INC.

L.M. (MIKE) CAUDILL

H.D. FLEMING ENTERPRISES, INC. FLEMING ENTERPRISES, INC. L.M. (MIKE) CAUDILL, P.S.C. MOUNTAIN COMPREHENSIVE SPECIALTY SERVICES, INC. QK TRANSPORT, INC. SUBTERRA, INC. LEAGUE OF KENTUCKY SPORTSMEN HABITAT IMPROVEMENT AND LAND ACQUISITION FOUNDATION, INC. KENTUCKY HEALTH CENTER NETWORK INCORPORATED COMMUNITY AGRICULTURAL AND NUTRITIONAL ENTERPRISES, INC. HELP END ADDICTION FOR LIFE CORPORATION

Related by address

No related companies by address

Date of last update: 14 Jan 2025

Sources: Kentucky Secretary of State

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