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COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY, INC.

Company Details

Name: COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY, INC.
Jurisdiction: Kentucky
Profit or Non-Profit: Non-profit
Legal type: Kentucky Corporation
Status: Active
Standing: Good
File Date: 20 Jun 1994 (31 years ago)
Organization Date: 20 Jun 1994 (31 years ago)
Last Annual Report: 19 Mar 2024 (10 months ago)
Organization Number: 0332143
Industry: Health Services
Number of Employees: Medium (20-99)
ZIP code: 42345
Primary County: Muhlenberg
Principal Office: 480 HOPKINSVILLE ST, SUITE 2, GREENVILLE, KY 42345
Place of Formation: KENTUCKY

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
FGW9Y14PTD35 2025-01-25 480 HOPKINSVILLE ST STE 2, GREENVILLE, KY, 42345, 1124, USA PO BOX 257, GREENVILLE, KY, 42345, 0257, USA

Business Information

Congressional District 02
State/Country of Incorporation KY, USA
Activation Date 2024-01-30
Initial Registration Date 2006-08-22
Entity Start Date 1994-06-13
Fiscal Year End Close Date Apr 30

Points of Contacts

Electronic Business
Title PRIMARY POC
Name ROGER ARBUCKLE
Address 480 HOPKINSVILLE STREET, GREENVILLE, KY, 42345, 1124, USA
Title ALTERNATE POC
Name KELLY DURALL
Address 480 HOPKINSVILLE STREET, GREENVILLE, KY, 42345, 1124, USA
Government Business
Title PRIMARY POC
Name ROGER ARBUCKLE
Address 480 HOPKINSVILLE STREET, GREENVILLE, KY, 42345, 1124, USA
Title ALTERNATE POC
Name LINDSAY DURALL
Address 480 HOPKINSVILLE STREET, GREENVILLE, KY, 42345, 1124, USA
Past Performance Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY 403(B) PLAN 2023 611268014 2024-10-14 COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY, INC. 120
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621112
Sponsor’s telephone number 2703385777
Plan sponsor’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY 403(B) PLAN 2022 611268014 2023-07-18 COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY, INC. 103
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621112
Sponsor’s telephone number 2703385777
Plan sponsor’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY 403(B) PLAN 2021 611268014 2022-09-08 COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY, INC. 109
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621112
Sponsor’s telephone number 2703385777
Plan sponsor’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY 403(B) PLAN 2020 611268014 2021-11-12 COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY, INC. 103
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621112
Sponsor’s telephone number 2703385777
Plan sponsor’s address 480 HOPKINSVILLE STREET, GREENVILLE, KY, 42345
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY 403(B) PLAN 2019 611268014 2020-11-13 COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY, INC. 82
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621112
Sponsor’s telephone number 2703385777
Plan sponsor’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY 403(B) PLAN 2018 611268014 2019-11-14 COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY 78
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 2703385777
Plan sponsor’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY 403(B) PLAN 2017 611268014 2019-01-22 COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY 68
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621111
Sponsor’s telephone number 2703385777
Plan sponsor’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY 403(B) PLAN 2016 611268014 2018-06-21 COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY 57
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621498
Sponsor’s telephone number 2703385777
Plan sponsor’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345

Signature of

Role Plan administrator
Date 2018-06-21
Name of individual signing JOSEPH SWAB
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-06-21
Name of individual signing JOSEPH SWAB
Valid signature Filed with authorized/valid electronic signature
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY 403(B) PLAN 2016 611268014 2018-06-20 COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY 57
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621498
Sponsor’s telephone number 2703385777
Plan sponsor’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345

Signature of

Role Plan administrator
Date 2018-06-20
Name of individual signing JOSEPH SWAB
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-06-20
Name of individual signing JOSEPH SWAB
Valid signature Filed with authorized/valid electronic signature
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY 403(B) PLAN 2016 611268014 2018-05-22 COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY 57
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621498
Sponsor’s telephone number 2703385777
Plan sponsor’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345

Signature of

Role Plan administrator
Date 2018-05-22
Name of individual signing JOSEPH SWAB
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-05-22
Name of individual signing JOSEPH SWAB
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/09/26/20160926085454P030011076439001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621498
Sponsor’s telephone number 2703385777
Plan sponsor’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345

Signature of

Role Plan administrator
Date 2016-09-26
Name of individual signing JOSEPH SWAB
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-09-26
Name of individual signing JOSEPH SWAB
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/10/23/20151023085519P040055766055001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621498
Sponsor’s telephone number 2703385777
Plan sponsor’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345

Signature of

Role Plan administrator
Date 2015-10-23
Name of individual signing JOSEPH SWAB
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/09/30/20140930161206P030010222701001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621498
Sponsor’s telephone number 2703385777
Plan sponsor’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345

Signature of

Role Plan administrator
Date 2014-09-30
Name of individual signing JOHN DAVID SANDEFUR
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/23/20130723142358P030309838355001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621498
Sponsor’s telephone number 2703385777
Plan sponsor’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345

Signature of

Role Plan administrator
Date 2013-07-23
Name of individual signing JOHN DAVID SANDEFUR
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621498
Sponsor’s telephone number 2703385777
Plan sponsor’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345

Plan administrator’s name and address

Administrator’s EIN 611268014
Plan administrator’s name COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY
Plan administrator’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345
Administrator’s telephone number 2703385777

Signature of

Role Plan administrator
Date 2012-09-13
Name of individual signing STEPHANIE WEBSTER
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/23/20130723141914P030309829139001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621498
Sponsor’s telephone number 2703385777
Plan sponsor’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345

Plan administrator’s name and address

Administrator’s EIN 611268014
Plan administrator’s name COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY
Plan administrator’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345
Administrator’s telephone number 2703385777

Signature of

Role Plan administrator
Date 2013-07-23
Name of individual signing JOHN DAVID SANDEFUR
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/07/23/20130723141329P030309813155001.pdf
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621498
Sponsor’s telephone number 2703385777
Plan sponsor’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345

Plan administrator’s name and address

Administrator’s EIN 611268014
Plan administrator’s name COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY
Plan administrator’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345
Administrator’s telephone number 2703385777

Signature of

Role Plan administrator
Date 2013-07-23
Name of individual signing JOHN DAVID SANDEFUR
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621498
Sponsor’s telephone number 2703385777
Plan sponsor’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345

Plan administrator’s name and address

Administrator’s EIN 611268014
Plan administrator’s name COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY
Plan administrator’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345
Administrator’s telephone number 2703385777

Signature of

Role Plan administrator
Date 2011-11-28
Name of individual signing STEPHANIE WEBSTER
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621498
Sponsor’s telephone number 2703385777
Plan sponsor’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345

Plan administrator’s name and address

Administrator’s EIN 611268014
Plan administrator’s name COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY
Plan administrator’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345
Administrator’s telephone number 2703385777

Signature of

Role Employer/plan sponsor
Date 2011-11-28
Name of individual signing STEPHANIE WEBSTER
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 1995-01-01
Business code 621498
Sponsor’s telephone number 2703385777
Plan sponsor’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345

Plan administrator’s name and address

Administrator’s EIN 611268014
Plan administrator’s name COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY
Plan administrator’s address 480 HOPKINSVILLE STREET, PO BOX 257, GREENVILLE, KY, 42345
Administrator’s telephone number 2703385777

Signature of

Role Employer/plan sponsor
Date 2011-11-28
Name of individual signing STEPHANIE WEBSTER
Valid signature Filed with authorized/valid electronic signature

Director

Name Role
Rosemary Buck Director
Amanda Henson Director
Jimmy Owens Director
VALENTINO S. SIMPAO Director
JEANNETTE WILLIAMS Director
RODNEY KIRLEY Director
LUCIEN CISNEY Director
RANDALL POWELL Director
Billy Steele Director
Elizabeth Gentry Director

Incorporator

Name Role
LUCIEN CISNEY Incorporator

Registered Agent

Name Role
ROGER ARBUCKLE Registered Agent

Officer

Name Role
Roger Arbuckle Officer

Filings

Name File Date
Annual Report 2024-03-19
Annual Report 2023-03-16
Annual Report 2022-03-07
Annual Report 2021-02-09
Annual Report 2020-02-13
Annual Report 2019-04-24
Annual Report 2018-04-11
Annual Report 2017-05-04
Annual Report 2016-03-14
Annual Report 2015-04-02

Date of last update: 23 Dec 2024

Sources: Kentucky Secretary of State