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MATHEW P. SAMUEL, M.D., P.S.C.

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Company Details

Name: MATHEW P. SAMUEL, M.D., P.S.C.
Legal type: Kentucky Professional Services Corp
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 09 Mar 1999 (26 years ago)
Organization Date: 09 Mar 1999 (26 years ago)
Last Annual Report: 07 May 2019 (6 years ago)
Organization Number: 0470684
ZIP code: 41101
City: Ashland, Summitt, Westwood
Primary County: Boyd County
Principal Office: TRI-STATE ARTHRITIS CENTER, 2154 CARTER AVE. SUITE D, ASHLAND, KY 41101
Place of Formation: KENTUCKY
Authorized Shares: 100

President

Name Role
Mathew P. Samuel President

Secretary

Name Role
Beena Samuel Secretary

Shareholder

Name Role
Mathew P. Samuel Shareholder

Incorporator

Name Role
MATHEW P SAMUEL Incorporator

Registered Agent

Name Role
MATHEW P SAMUEL Registered Agent

National Provider Identifier

NPI Number:
1174741425

Authorized Person:

Name:
DR. MATHEW P SAMUEL
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
174400000X - Specialist
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
611341052
Plan Year:
2019
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2017
Number Of Participants:
6
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
6
Sponsors Telephone Number:

Assumed Names

Name Status Expiration Date
TRI-STATE ARTHRITIS CENTER Inactive 2020-05-19

Filings

Name File Date
Administrative Dissolution 2020-10-08
Annual Report 2019-05-07
Annual Report 2018-07-05
Annual Report 2017-03-13
Annual Report 2016-05-18

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Sources: Kentucky Secretary of State