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GLENN R. WOMACK, M.D., P.S.C.

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Company Details

Name: GLENN R. WOMACK, M.D., P.S.C.
Legal type: Kentucky Professional Services Corp
Status: Inactive
Standing: Good
Profit or Non-Profit: Profit
File Date: 06 Jul 1989 (36 years ago)
Organization Date: 06 Jul 1989 (36 years ago)
Last Annual Report: 10 Aug 2020 (5 years ago)
Organization Number: 0260527
ZIP code: 41041
City: Flemingsburg
Primary County: Fleming County
Principal Office: P O BOX 29, 1963 MT CARMEL RD, FLEMINGSBURG, KY 41041
Place of Formation: KENTUCKY
Authorized Shares: 1000

President

Name Role
Glenn R Flemingsburg President

Secretary

Name Role
Dolores E Womack Secretary

Incorporator

Name Role
GLENN R. WOMACK,M.D. Incorporator

Director

Name Role
GLENN R. WOMACK, M.D. Director

Registered Agent

Name Role
GARY R. WEITKAMP Registered Agent

Treasurer

Name Role
Dolores E Womack Treasurer

Shareholder

Name Role
Glenn R Womack Shareholder

National Provider Identifier

NPI Number:
1710141585

Authorized Person:

Name:
DR. GLENN R WOMACK
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
261Q00000X - Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
6068492025

Assumed Names

Name Status Expiration Date
MAY'S LICK MEDICAL CLINIC Inactive 2018-07-15
BUFFALO TRACE FAMILY HEALTH CARE Inactive 2018-07-15

Filings

Name File Date
Dissolution 2020-11-23
Annual Report 2020-08-10
Registered Agent name/address change 2020-02-17
Annual Report 2019-04-09
Principal Office Address Change 2018-09-18

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Sources: Kentucky Secretary of State