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BLUEGRASS GASTROENTEROLOGY, P.S.C.

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Company Details

Name: BLUEGRASS GASTROENTEROLOGY, P.S.C.
Legal type: Kentucky Professional Services Corp
Status: Inactive
Standing: Good
Profit or Non-Profit: Profit
File Date: 04 Apr 1997 (28 years ago)
Organization Date: 04 Apr 1997 (28 years ago)
Last Annual Report: 30 Jun 2017 (8 years ago)
Organization Number: 0431059
ZIP code: 42003
City: Paducah
Primary County: McCracken County
Principal Office: 2605 KY AVE, STE. 202, PADUCAH, KY 42003
Place of Formation: KENTUCKY
Authorized Shares: 1000

Registered Agent

Name Role
DR RUSSELL CARTER Registered Agent

President

Name Role
RUSSELL W CARTER President

Vice President

Name Role
TIMOTHY E SHIBEN Vice President

Director

Name Role
RUSSELL W CARTER Director
TIMOTHY E SHIBEN Director
PAMELA A REED Director
RICK J MCCOMBS Director

Shareholder

Name Role
TIMOTHY E SHIBEN Shareholder
RUSSELL W CARTER Shareholder
PAMELA A REED Shareholder
RICK J MCCOMBS Shareholder

Secretary

Name Role
PAM REED Secretary

Treasurer

Name Role
RICK MCCOMBS Treasurer

Incorporator

Name Role
DR RUSSELL CARTER Incorporator

National Provider Identifier

NPI Number:
1770643561

Authorized Person:

Name:
DR. RUSSELL W CARTER
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
207RG0100X - Gastroenterology Physician
Is Primary:
Yes

Contacts:

Fax:
2704414707

Form 5500 Series

Employer Identification Number (EIN):
311514828
Plan Year:
2015
Number Of Participants:
29
Sponsors Telephone Number:
Plan Year:
2015
Number Of Participants:
32
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
34
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
37
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
35
Sponsors Telephone Number:

Filings

Name File Date
Dissolution 2018-04-19
Annual Report 2017-06-30
Principal Office Address Change 2017-06-30
Annual Report 2016-09-08
Annual Report 2015-06-30

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Sources: Kentucky Secretary of State