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APPALACHIAN PHYSICIANS, P.S.C.

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Company Details

Name: APPALACHIAN PHYSICIANS, P.S.C.
Legal type: Kentucky Professional Services Corp
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 17 Sep 1996 (29 years ago)
Organization Date: 17 Sep 1996 (29 years ago)
Last Annual Report: 19 Aug 2021 (4 years ago)
Organization Number: 0421506
ZIP code: 40744
City: London
Primary County: Laurel County
Principal Office: 35 SADDLEBROOK GARDEN HOMES RD, LONDON, KY 40744
Place of Formation: KENTUCKY
Authorized Shares: 1000

Incorporator

Name Role
DEEPAK SRIVASTAVA, MD Incorporator

Sole Officer

Name Role
Deepak Srivastava Sole Officer

Director

Name Role
DEEPAK SIRVASTAVA Director

Shareholder

Name Role
Deepak Srivastava Shareholder

Registered Agent

Name Role
DEEPAK SRIVASTAVA Registered Agent

National Provider Identifier

NPI Number:
1518992023

Authorized Person:

Name:
DR. DEEPAK SRIVASTAVA
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
208D00000X - General Practice Physician
Is Primary:
No
Selected Taxonomy:
261QR1300X - Rural Health Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
6065980983

Form 5500 Series

Employer Identification Number (EIN):
611310916
Plan Year:
2011
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2010
Number Of Participants:
8
Sponsors Telephone Number:
Plan Year:
2009
Number Of Participants:
7
Sponsors Telephone Number:

Assumed Names

Name Status Expiration Date
HYDEN RURAL HEALTH CLINIC Active 2026-08-27
HAZARD RURAL HEALTH CLINIC Active 2026-08-27
APPALACHIAN CLINIC Inactive 2015-10-22
APPALACHIAN CLINIC - WOOTON Inactive 2015-10-22

Filings

Name File Date
Sixty Day Notice Return 2022-10-06
Administrative Dissolution 2022-10-04
Certificate of Assumed Name 2021-08-27
Certificate of Assumed Name 2021-08-27
Registered Agent name/address change 2021-08-19

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Sources: Kentucky Secretary of State