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ERTEL MEDICINE & PEDIATRICS, PSC

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Company Details

Name: ERTEL MEDICINE & PEDIATRICS, PSC
Legal type: Kentucky Professional Services Corp
Status: Inactive
Standing: Good
Profit or Non-Profit: Profit
File Date: 02 Jun 2000 (25 years ago)
Organization Date: 02 Jun 2000 (25 years ago)
Last Annual Report: 01 Jun 2016 (9 years ago)
Organization Number: 0495504
ZIP code: 40391
City: Winchester, Ford
Primary County: Clark County
Principal Office: 1520 BOONESBORO RD., WINCHESTER, KY 40391
Place of Formation: KENTUCKY
Authorized Shares: 2000

Secretary

Name Role
Larry Ertel Secretary

Treasurer

Name Role
Larry Ertel Treasurer

President

Name Role
Larry Ertel President

Director

Name Role
Larry Ertel Director

Shareholder

Name Role
Larry Ertel Shareholder

Registered Agent

Name Role
LARRY ERTEL, M.D. Registered Agent

Incorporator

Name Role
LARRY ERTEL, M.D. Incorporator

National Provider Identifier

NPI Number:
1003842501

Authorized Person:

Name:
LARRY ERTEL
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No
Selected Taxonomy:
208000000X - Pediatrics Physician
Is Primary:
No
Selected Taxonomy:
261QR1300X - Rural Health Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
8597440042

Former Company Names

Name Action
LARRY ERTEL, M.D., P.S.C. Old Name

Filings

Name File Date
Dissolution 2017-01-06
Annual Report 2016-06-01
Annual Report 2015-04-29
Annual Report 2014-03-26
Annual Report 2013-02-01

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Sources: Kentucky Secretary of State