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PINEVILLE COMMUNITY HOSPITAL ASSOCIATION, INC.

Company Details

Name: PINEVILLE COMMUNITY HOSPITAL ASSOCIATION, INC.
Legal type: Kentucky Corporation
Status: Inactive
Standing: Bad
Profit or Non-Profit: Non-profit
File Date: 24 Sep 1953 (72 years ago)
Organization Date: 24 Sep 1953 (72 years ago)
Last Annual Report: 18 Jul 2018 (7 years ago)
Organization Number: 0041539
ZIP code: 40977
City: Pineville, Balkan, Callaway, Cary, Chenoa, Clear Cr...
Primary County: Bell County
Principal Office: 850 RIVERVEIW AVE., PINEVILLE, KY 40977
Place of Formation: KENTUCKY

Director

Name Role
JERRY G WOOLUM Director
John Jones Director
Charles Bishop Director
JAY STEEL Director
ADAM STACY, JR., M. D. Director
DAVID GAMBREL Director
John Combs Director
Mansfield Dixon Director
C. B. STACY, M. D. Director
EDWARD S. WILSON, M. D. Director

Incorporator

Name Role
ADAM STACY, JR., M. D. Incorporator
EDWARD S. WILSON Incorporator
EDWARD WILSON Incorporator
JAMES S. GOLDEN, M. D. Incorporator
GEORGE M. ASHER, M. D. Incorporator

Chairman

Name Role
Charles Bishop Chairman

Registered Agent

Name Role
CHARLES M BISHOP Registered Agent

National Provider Identifier

NPI Number:
1861843401

Authorized Person:

Name:
MR. KEVIN COUCH
Role:
CONTROLLER
Phone:

Taxonomy:

Selected Taxonomy:
275N00000X - Medicare Defined Swing Bed Hospital Unit
Is Primary:
Yes

Contacts:

Fax:
6063372871

Form 5500 Series

Employer Identification Number (EIN):
610541901
Plan Year:
2018
Number Of Participants:
202
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
308
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
372
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
346
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
313
Sponsors Telephone Number:

Assumed Names

Name Status Expiration Date
TOTAL CARE PHARMACY PCH Inactive 2021-09-20
TOTAL CARE RURAL CLINIC Inactive 2021-06-03

Filings

Name File Date
Administrative Dissolution 2019-10-16
Annual Report 2018-07-18
Registered Agent name/address change 2018-07-18
Reinstatement 2017-10-13
Reinstatement Certificate of Existence 2017-10-13

Sources: Kentucky Secretary of State