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  5. LEITCHFIELD PEDIATRIC CLINIC, P.S.C.

LEITCHFIELD PEDIATRIC CLINIC, P.S.C.

Company Details

Name: LEITCHFIELD PEDIATRIC CLINIC, P.S.C.
Jurisdiction: Kentucky
Profit or Non-Profit: Profit
Legal type: Kentucky Professional Services Corp
Status: Active
Standing: Good
File Date: 22 Jul 1996 (28 years ago)
Organization Date: 22 Jul 1996 (28 years ago)
Last Annual Report: 25 Mar 2024 (10 months ago)
Organization Number: 0419126
Industry: Health Services
Number of Employees: Medium (20-99)
ZIP code: 42754
Primary County: Grayson
Principal Office: 901 WALLACE AVE, LEITCHFIELD, KY 42754
Place of Formation: KENTUCKY
Authorized Shares: 100

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LEITCHFIELD PEDIATRIC CLINIC, P.S.C. 401(K) PROFIT SHARING PLAN 2013 611306896 2014-03-21 LEITCHFIELD PEDIATRIC CLINIC, P.S.C. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 5022595641
Plan sponsor’s address 908 WALLACE AVENUE, SUITE 108, LEITCHFIELD, KY, 427541478

Signature of
Role Plan administrator
Date 2014-03-21
Name of individual signing JOSEPH LEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-03-21
Name of individual signing JOSEPH LEE
Valid signature Filed with authorized/valid electronic signature
LEITCHFIELD PEDIATRIC CLINIC, P.S.C. 401(K) PROFIT SHARING PLAN 2012 611306896 2013-03-07 LEITCHFIELD PEDIATRIC CLINIC, P.S.C. 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 5022595641
Plan sponsor’s address 908 WALLACE AVENUE, SUITE 108, LEITCHFIELD, KY, 427541478

Signature of
Role Plan administrator
Date 2013-03-07
Name of individual signing JOSEPH LEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-03-07
Name of individual signing JOSEPH LEE
Valid signature Filed with authorized/valid electronic signature
LEITCHFIELD PEDIATRIC CLINIC, P.S.C. 401(K) PROFIT SHARING PLAN 2011 611306896 2012-03-05 LEITCHFIELD PEDIATRIC CLINIC, P.S.C. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 5022595641
Plan sponsor’s address 908 WALLACE AVENUE, SUITE 108, LEITCHFIELD, KY, 427541478

Plan administrator’s name and address
Administrator’s EIN 611306896
Plan administrator’s name LEITCHFIELD PEDIATRIC CLINIC, P.S.C.
Plan administrator’s address 908 WALLACE AVENUE, SUITE 108, LEITCHFIELD, KY, 427541478
Administrator’s telephone number 5022595641

Signature of
Role Plan administrator
Date 2012-03-05
Name of individual signing JOSEPH LEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-03-05
Name of individual signing JOSEPH LEE
Valid signature Filed with authorized/valid electronic signature
LEITCHFIELD PEDIATRIC CLINIC, P.S.C. 401(K) PROFIT SHARING PLAN 2010 611306896 2011-02-22 LEITCHFIELD PEDIATRIC CLINIC, P.S.C. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2702595641
Plan sponsor’s address 908 WALLACE AVENUE, SUITE 108, LEITCHFIELD, KY, 427541478

Plan administrator’s name and address
Administrator’s EIN 611306896
Plan administrator’s name LEITCHFIELD PEDIATRIC CLINIC, P.S.C.
Plan administrator’s address 908 WALLACE AVENUE, SUITE 108, LEITCHFIELD, KY, 427541478
Administrator’s telephone number 2702595641

Signature of
Role Plan administrator
Date 2011-02-22
Name of individual signing JOSEPH LEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-02-22
Name of individual signing JOSEPH LEE
Valid signature Filed with authorized/valid electronic signature
LEITCHFIELD PEDIATRIC CLINIC, P.S.C. 401(K) PROFIT SHARING PLAN 2009 611306896 2010-07-19 LEITCHFIELD PEDIATRIC CLINIC, P.S.C. 22
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1993-01-01
Business code 621111
Sponsor’s telephone number 2702595641
Plan sponsor’s address 908 WALLACE AVENUE, SUITE 108, LEITCHFIELD, KY, 427541478

Plan administrator’s name and address
Administrator’s EIN 611306896
Plan administrator’s name LEITCHFIELD PEDIATRIC CLINIC, P.S.C.
Plan administrator’s address 908 WALLACE AVENUE, SUITE 108, LEITCHFIELD, KY, 427541478
Administrator’s telephone number 2702595641

Signature of
Role Plan administrator
Date 2010-07-19
Name of individual signing JOSEPH M LEE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-07-19
Name of individual signing JOSEPH M LEE
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
ANTHONY SMITH Registered Agent

President

Name Role
John E Evans President

Vice President

Name Role
Anthony K Smtih Vice President

Director

Name Role
John E Evans Director
Anthony K Smith Director

Shareholder

Name Role
John E Evans Shareholder
Anthony K Smith Shareholder

Incorporator

Name Role
JOSEPH M. LEE, M.D. Incorporator

Filings

Name File Date
Annual Report 2024-03-25
Annual Report 2023-03-20
Annual Report 2022-03-10
Annual Report 2021-04-13
Annual Report 2020-02-13
Registered Agent name/address change 2019-04-19
Principal Office Address Change 2019-04-19
Annual Report 2019-04-19
Annual Report 2018-04-13
Annual Report 2017-04-21

Related by officers

ANTHONY SMITH

GATEWAY CLOGGERS KNOTT COUNTY CARPET, INC. SMITH LUMBER COMPANY, INCORPORATED SMITH FURNITURE AND BUILDING SUPPLY, INC. CANDY COAL CORPORATION, INC. OWENS CUSTOM BUILDERS, INC. JACOB WELLS CHURCH RESTORATION MINISTRIES, INC. CUMBERLAND COUNTY AGRICULTURAL DEVELOPMENT COUNCIL, INC. MAYSVILLE POST 124 OF AMVETS, INC. 2 NOT 1: FATHERHOOD & FAMILIES, INC.

Related by address

901 WALLACE AVE, LEITCHFIELD, KY 42754

LEITCHFIELD PEDIATRIC PARTNERS, LLC

Date of last update: 24 Dec 2024

Sources: Kentucky Secretary of State

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