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LAKE CUMBERLAND WOMEN'S HEALTH SPECIALISTS, P.S.C.

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Company Details

Name: LAKE CUMBERLAND WOMEN'S HEALTH SPECIALISTS, P.S.C.
Legal type: Kentucky Professional Services Corp
Status: Inactive
Standing: Good
Profit or Non-Profit: Profit
File Date: 20 Mar 1991 (34 years ago)
Organization Date: 20 Mar 1991 (34 years ago)
Last Annual Report: 26 Apr 2018 (7 years ago)
Organization Number: 0284239
ZIP code: 42503
City: Somerset
Primary County: Pulaski County
Principal Office: 333 BOGLE ST., SOMERSET, KY 42503
Place of Formation: KENTUCKY
Authorized Shares: 2000

Director

Name Role
BRIAN K. PRIDDLE, M.D. Director
DALE E. RUTLEDGE, M.D. Director
John Bruner Director
Dale Rutledge Director
Brian Priddle Director
Kevin Crosslin Director

Incorporator

Name Role
BRIAN K. PRIDDLE, M.D. Incorporator
DALE E. RUTLEDGE, M.D. Incorporator

President

Name Role
Brian Priddle President

Secretary

Name Role
John Bruner Secretary
Kevin Crosslin Secretary

Vice President

Name Role
Dale Rutledge Vice President

Registered Agent

Name Role
BRIAN K. PRIDDLE, M.D. Registered Agent

Shareholder

Name Role
John Bruner Shareholder
Dale Rutledge Shareholder
Brian Priddle Shareholder
Kevin Crosslin Shareholder

National Provider Identifier

NPI Number:
1578600367

Authorized Person:

Name:
DR. DALE EDWARD RUTLEDGE I
Role:
PHYSICIAN VP
Phone:

Taxonomy:

Selected Taxonomy:
363LX0001X - Obstetrics & Gynecology Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
207V00000X - Obstetrics & Gynecology Physician
Is Primary:
Yes

Contacts:

Fax:
6066782807

Form 5500 Series

Employer Identification Number (EIN):
611196721
Plan Year:
2013
Number Of Participants:
36
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
39
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
37
Sponsors Telephone Number:
Plan Year:
2010
Number Of Participants:
33
Sponsors Telephone Number:
Plan Year:
2009
Number Of Participants:
31
Sponsors Telephone Number:

Filings

Name File Date
Dissolution 2019-05-29
Annual Report 2018-04-26
Annual Report 2017-04-17
Annual Report 2016-05-20
Annual Report 2015-05-30

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Sources: Kentucky Secretary of State