| Name: | KENTUCKIANA PULMONARY ASSOCIATES, PLLC |
| Legal type: | Kentucky Limited Liability Company |
| Status: | Inactive |
| Standing: | Good |
| Profit or Non-Profit: | Profit |
| File Date: | 04 Sep 1998 (27 years ago) |
| Organization Date: | 04 Sep 1998 (27 years ago) |
| Last Annual Report: | 10 Feb 2021 (4 years ago) |
| Managed By: | Members |
| Organization Number: | 0461620 |
| ZIP code: | 40202 |
| City: | Louisville |
| Primary County: | Jefferson County |
| Principal Office: | 100 W. MARKET ST., SUITE 2, LOUISVILLE, KY 40202 |
| Place of Formation: | KENTUCKY |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KENTUCKIANA PULMONARY ASSOCIATES, PLLC PROFIT SHARING/401(K) PLAN AND TRUST AGREEMENT | 2017 | 611333647 | 2018-10-02 | KENTUCKIANA PULMONARY ASSOCIATES, PLLC | 41 | |||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2018-10-02 |
| Name of individual signing | KEITH VANDERPOOL |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 1999-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 5025871869 |
| Plan sponsor’s address | 100 W. MARKET STREET SUITE #2, LOUISVILLE, KY, 40202 |
Signature of
| Role | Plan administrator |
| Date | 2016-10-17 |
| Name of individual signing | KEITH VANDERPOOL |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 1999-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 5025871869 |
| Plan sponsor’s address | 100 W. MARKET STREET SUITE #2, LOUISVILLE, KY, 40202 |
Signature of
| Role | Plan administrator |
| Date | 2015-09-03 |
| Name of individual signing | KEITH VANDERPOOL |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 1999-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 5025871869 |
| Plan sponsor’s address | 100 W. MARKET STREET SUITE #2, LOUISVILLE, KY, 40202 |
Signature of
| Role | Plan administrator |
| Date | 2014-10-02 |
| Name of individual signing | KEITH VANDERPOOL |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 1999-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 5025871869 |
| Plan sponsor’s address | 100 W. MARKET STREET SUITE #2, LOUISVILLE, KY, 40202 |
Signature of
| Role | Plan administrator |
| Date | 2013-10-14 |
| Name of individual signing | KEITH VANDERPOOL |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 1999-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 5025871869 |
| Plan sponsor’s address | 100 W. MARKET STREET, SUITE #2, LOUISVILLE, KY, 40202 |
Plan administrator’s name and address
| Administrator’s EIN | 611333647 |
| Plan administrator’s name | KENTUCKIANA PULMONARY ASSOCIATES, PLLC |
| Plan administrator’s address | 100 W. MARKET STREET, SUITE #2, LOUISVILLE, KY, 40202 |
| Administrator’s telephone number | 5025871869 |
Signature of
| Role | Plan administrator |
| Date | 2012-09-05 |
| Name of individual signing | KEITH VANDERPOOL |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 1999-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 5025871869 |
| Plan sponsor’s address | 100 W. MARKET STREET SUITE #2, LOUISVILLE, KY, 40202 |
Plan administrator’s name and address
| Administrator’s EIN | 611333647 |
| Plan administrator’s name | KENTUCKIANA PULMONARY ASSOCIATES, PLLC |
| Plan administrator’s address | 100 W. MARKET STREET SUITE #2, LOUISVILLE, KY, 40202 |
| Administrator’s telephone number | 5025871869 |
Signature of
| Role | Plan administrator |
| Date | 2011-07-25 |
| Name of individual signing | KEITH VANDERPOOL |
| Valid signature | Filed with authorized/valid electronic signature |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 1999-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 5025871869 |
| Plan sponsor’s address | 100 W. MARKET STREET SUITE #2, LOUISVILLE, KY, 40202 |
Plan administrator’s name and address
| Administrator’s EIN | 611333647 |
| Plan administrator’s name | KENTUCKIANA PULMONARY ASSOCIATES, PLLC |
| Plan administrator’s address | 100 W. MARKET STREET SUITE #2, LOUISVILLE, KY, 40202 |
| Administrator’s telephone number | 5025871869 |
Signature of
| Role | Employer/plan sponsor |
| Date | 2011-07-13 |
| Name of individual signing | KEITH VANDERPOOL |
| Valid signature | Filed with incorrect/unrecognized electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 002 |
| Effective date of plan | 1999-01-01 |
| Business code | 621111 |
| Sponsor’s telephone number | 5025871869 |
| Plan sponsor’s address | 100 W. MARKET STREET SUITE 2, LOUISVILLE, KY, 40202 |
Plan administrator’s name and address
| Administrator’s EIN | 611333647 |
| Plan administrator’s name | KENTUCKIANA PULMONARY ASSOCIATES, PLLC |
| Plan administrator’s address | 100 W. MARKET STREET SUITE 2, LOUISVILLE, KY, 40202 |
| Administrator’s telephone number | 5025871869 |
Signature of
| Role | Plan administrator |
| Date | 2010-09-24 |
| Name of individual signing | KEITH VANDERPOOL |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| THOMAS A. HOY | Organizer |
| Name | Role |
|---|---|
| LIRA JOHNSON | Registered Agent |
| Name | Role |
|---|---|
| CHRISTOPHER W. BARBER | Member |
| RAHEL A. TEFERRA | Member |
| J WESLEY MCCONNELL | Member |
| ZAKA U. KHAN | Member |
| AMADEO LUCAS ABRAHAM | Member |
| MUHAMMAD YASIN | Member |
| Name | Status | Expiration Date |
|---|---|---|
| COMPMED | Inactive | 2014-08-27 |
| Name | File Date |
|---|---|
| Dissolution | 2022-02-21 |
| Annual Report | 2021-02-10 |
| Annual Report | 2020-02-20 |
| Registered Agent name/address change | 2019-04-02 |
| Annual Report | 2019-04-02 |
| Annual Report | 2018-05-01 |
| Annual Report | 2017-04-27 |
| Annual Report | 2016-03-15 |
| Annual Report | 2015-05-12 |
| Annual Report | 2014-03-31 |
| Contract Type | Award or IDV Flag | PIID | Start Date | Current End Date | Potential End Date | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| No data | IDV | W912QR12A0027 | 2012-05-09 | No data | No data | |||||||||||||||||||||||||||
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| Obligated Amount | 0.00 |
| Potential Award Amount | 25000.00 |
Description
| Title | SETTING UP BPA FOR PHYSICAL EXAMINATIONS OF EMPLOYEES AT MARKLAND LOCKS AND DAMS, WARSAW, KY. KENTUCKIANA PULMONARY ASSOCIATES, PLLC. |
| NAICS Code | 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS) |
| Product and Service Codes | Q521: MEDICAL- PULMONARY |
Recipient Details
| Recipient | KENTUCKIANA PULMONARY ASSOCIATES, PLLC |
| UEI | HV5XD8D7Q3U6 |
| Legacy DUNS | 085593155 |
| Recipient Address | 100 W MARKET ST STE 2, LOUISVILLE, JEFFERSON, KENTUCKY, 402022018, UNITED STATES |
| Unique Award Key | CONT_AWD_0003_9700_W912QR10A0043_9700 |
| Awarding Agency | Department of Defense |
| Link | View Page |
Award Amounts
| Obligated Amount | 8180.00 |
| Current Award Amount | 8180.00 |
| Potential Award Amount | 8180.00 |
Description
| Title | DE-OBLIGATE REMAINING FUNDS FOR EMPLOYEE PHYSICALS |
| NAICS Code | 621511: MEDICAL LABORATORIES |
| Product and Service Codes | Q999: OTHER MEDICAL SERVICES |
Recipient Details
| Recipient | KENTUCKIANA PULMONARY ASSOCIATES, PLLC |
| UEI | HV5XD8D7Q3U6 |
| Legacy DUNS | 085593155 |
| Recipient Address | 100 W MARKET ST STE 2, LOUISVILLE, JEFFERSON, KENTUCKY, 402022018, UNITED STATES |
| Unique Award Key | CONT_IDV_W912QR11A0014_9700 |
| Awarding Agency | Department of Defense |
| Link | View Page |
Award Amounts
| Obligated Amount | 0.00 |
| Potential Award Amount | 8000.00 |
Description
| Title | PHYSICALS FOR JT MYER L/D |
| NAICS Code | 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS) |
| Product and Service Codes | Q521: PULMONARY SERVICES |
Recipient Details
| Recipient | KENTUCKIANA PULMONARY ASSOCIATES, PLLC |
| UEI | HV5XD8D7Q3U6 |
| Legacy DUNS | 085593155 |
| Recipient Address | 100 W MARKET ST STE 2, LOUISVILLE, JEFFERSON, KENTUCKY, 402022018, UNITED STATES |
| Unique Award Key | CONT_IDV_W912QR10A0043_9700 |
| Awarding Agency | Department of Defense |
| Link | View Page |
Award Amounts
| Obligated Amount | 0.00 |
| Potential Award Amount | 10000.00 |
Description
| Title | ADD AUTHORIZED CALLER, MEDICAL PHYSICALS FOR LOUISVILLE REPAIR STATION, LOUISVILLE, KY |
| NAICS Code | 621511: MEDICAL LABORATORIES |
| Product and Service Codes | Q999: OTHER MEDICAL SERVICES |
Recipient Details
| Recipient | KENTUCKIANA PULMONARY ASSOCIATES, PLLC |
| UEI | HV5XD8D7Q3U6 |
| Legacy DUNS | 085593155 |
| Recipient Address | 100 W MARKET ST STE 2, LOUISVILLE, JEFFERSON, KENTUCKY, 402022018, UNITED STATES |
| Unique Award Key | CONT_IDV_W912QR10A0042_9700 |
| Awarding Agency | Department of Defense |
| Link | View Page |
Award Amounts
| Obligated Amount | 0.00 |
| Potential Award Amount | 0.00 |
Description
| Title | PROVIDE MEDICAL PHYSICALS INCLUDING LAB WORK FOR EMPLOYEES OF THE MARKLAND LOCKS & DAM, OHIO RIVER, WARSAW, KY |
| NAICS Code | 621511: MEDICAL LABORATORIES |
| Product and Service Codes | Q999: OTHER MEDICAL SERVICES |
Recipient Details
| Recipient | KENTUCKIANA PULMONARY ASSOCIATES, PLLC |
| UEI | HV5XD8D7Q3U6 |
| Legacy DUNS | 085593155 |
| Recipient Address | 100 W MARKET ST STE 2, LOUISVILLE, JEFFERSON, KENTUCKY, 402022018, UNITED STATES |
| Unique Award Key | CONT_IDV_W912QR10A0022_9700 |
| Awarding Agency | Department of Defense |
| Link | View Page |
Award Amounts
| Obligated Amount | 0.00 |
| Potential Award Amount | 2000.00 |
Description
| Title | 1. THIS BLANKET PURCHASE AGREEMENT (BPA) IS ESTABLISHED TO PROVIDE EMPLOYEE PHYSICALS AT JOHN T. MYERS LOCK AND DAM, MT. VERNON, IN, ON AN AS-NEEDED BASIS , WHEN REQUESTED BY THE AUTHORIZED CALLERS (AS LISTED BELOW). NO INDIVIDUAL CALL UNDER THIS AGREEMENT SHALL EXCEED $3,000.00 AND $8,000.00 FOR CONTRACTING DIVISION. THE BPA IS EFFECTIVE FOR THE PERIOD OF 05 JANUARY 2010 THRU 04 JANUARY 2011. 2. THE GOVERNMENT IS OBLIGATED ONLY TO THE EXTENT OF AUTHORIZED CALLS ACTUALLY PLACED AGAINST THIS BLANKET PURCHASE AGREEMENT. 3. THE PRICES TO THE GOVERNMENT WILL BE AS LOW AS OR LOWER THAN THOSE CHARGED YOUR MOST FAVORED CUSTOMER, IN ADDITION TO ANY DISCOUNTS FOR PROMPT PAYMENT. 4. ONLY THE CONTRACTING OFFICER OR THE CONTRACTING OFFICER S AUTHORIZED REPRESENTATIVES MAY PLACE CALLS AGAINST THIS AGREEMENT. THE FOLLOWING ARE DESIGNATED AS AUTHORIZED REPRESENTATIVES OF THE CONTRACTING OFFICER AND MAY PLACE INDIVIDUAL CALLS NOT TO EXCEED $3,000.00. AUTHORIZED CALLERS: ROBERT GIBBS (812) 838-5836 DENEISE KRAMER (812) 838-5836 CONTRACTING DIVISION CALL LIMIT $10,000.00: JANET S. CRUM (502) 315-6185 5. ALL DELIVERIES MADE UNDER THIS AGREEMENT WILL BE ACCOMPANIED BY DELIVERY TICKETS OR SALES SLIPS, IN DUPLICATE, AND WILL SHOW THE FOLLOWING: NAME OF SUPPLIER, NUMBER OF THIS AGREEMENT, DATE OF CALL, ITEMIZED LIST OF SUPPLIES OR SERVICES FURNISHED, QUANTITY, UNIT PRICE, AND EXTENSION OF EACH LESS APPLICABLE DISCOUNTS, AND DATE OF DELIVERY OR SHIPMENT. THE DELIVERY TICKET MUST BE SIGNED BY THE GOVERNMENT EMPLOYEE TO WHOM DELIVERY IS MADE. 6. METHOD OF PAYMENT FOR SERVICES UNDER $3,000 WILL BE VISA; METHOD OF PAYMENT FOR SERVICES OVER $3,000 WILL BE USACE FINANCE CENTER. 7. REQUESTS WILL BE MADE ORALLY. 8. CONTRACTOR WILL BE PAID FOR ACTUAL USAGE ONLY. 9. AT THE OPTION OF THE GOVERNMENT, THIS BPA MAY BE RENEWED BY MODIFICATION FOR FOUR ADDITIONAL ONE-YEAR PERIODS AS FOLLOWS: OPTION YEAR 1: 05 JANUARY 2011 THRU 04 JANUARY 2012 OPTION YEAR 2: 05 JANUARY 2012 THRU 04 JANUARY 2013 OPTION YEAR 3: 05 JANUARY 2013 THRU 04 JANUARY 2014 OPTION YEAR 4: 05 JANUARY 2014 THRU 04 JANUARY 2015 |
| NAICS Code | 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS) |
| Product and Service Codes | Q521: PULMONARY SERVICES |
Recipient Details
| Recipient | KENTUCKIANA PULMONARY ASSOCIATES, PLLC |
| UEI | HV5XD8D7Q3U6 |
| Legacy DUNS | 085593155 |
| Recipient Address | 224 E BROADWAY STE 700, LOUISVILLE, JEFFERSON, KENTUCKY, 402022018, UNITED STATES |
| Unique Award Key | CONT_IDV_W912QR09A0005_9700 |
| Awarding Agency | Department of Defense |
| Link | View Page |
Award Amounts
| Obligated Amount | 0.00 |
| Potential Award Amount | 6000.00 |
Description
| Title | MEDICAL PHYSICALS FOR CANNELTON |
| NAICS Code | 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS) |
| Product and Service Codes | Q201: GENERAL HEALTH CARE SERVICES |
Recipient Details
| Recipient | KENTUCKIANA PULMONARY ASSOCIATES, PLLC |
| UEI | HV5XD8D7Q3U6 |
| Legacy DUNS | 085593155 |
| Recipient Address | 224 E BROADWAY STE 700, LOUISVILLE, JEFFERSON, KENTUCKY, 402022018, UNITED STATES |
| Unique Award Key | CONT_IDV_W912QR05A0040_9700 |
| Awarding Agency | Department of Defense |
| Link | View Page |
Description
| Title | EMPLOYEE PHYSICALS OPTION YEAR 3 |
| NAICS Code | 621111: OFFICES OF PHYSICIANS (EXCEPT MENTAL HEALTH SPECIALISTS) |
| Product and Service Codes | Q201: GENERAL HEALTH CARE SERVICES |
Recipient Details
| Recipient | KENTUCKIANA PULMONARY ASSOCIATES, PLLC |
| UEI | HV5XD8D7Q3U6 |
| Legacy DUNS | 085593155 |
| Recipient Address | 224 E BROADWAY STE 700, LOUISVILLE, 402022018, UNITED STATES |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2968407204 | 2020-04-16 | 0457 | PPP | 100 W MARKET ST STE 2, LOUISVILLE, KY, 40202-1332 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Sources: Kentucky Secretary of State
