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PADUCAH PRIMARY CARE, P.S.C.

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Company Details

Name: PADUCAH PRIMARY CARE, P.S.C.
Legal type: Kentucky Professional Services Corp
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 28 Apr 1995 (30 years ago)
Organization Date: 28 Apr 1995 (30 years ago)
Last Annual Report: 19 Jun 2019 (6 years ago)
Organization Number: 0346105
Principal Office: 4620 VILLAGE SQUARE DRIVE, P O BOX 9100, PADUCAH, KY 420029100
Place of Formation: KENTUCKY
Authorized Shares: 1000

Incorporator

Name Role
RONALD L. WILSON Incorporator

Registered Agent

Name Role
RONALD L. WILSON, M.D. Registered Agent

President

Name Role
Ronald L Wilson President

Secretary

Name Role
Richard S Wilson Secretary

Shareholder

Name Role
Ronald L Wilson Shareholder
Richard S Wilson Shareholder

National Provider Identifier

NPI Number:
1497892103

Authorized Person:

Name:
DR. RONALD L WILSON
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
2704428783

Form 5500 Series

Employer Identification Number (EIN):
611281680
Plan Year:
2020
Number Of Participants:
13
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
13
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
13
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
14
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
13
Sponsors Telephone Number:

Filings

Name File Date
Administrative Dissolution 2020-10-08
Registered Agent name/address change 2019-09-25
Principal Office Address Change 2019-09-25
Annual Report 2019-06-19
Annual Report 2018-07-02

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Sources: Kentucky Secretary of State