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  5. PREMIER EYE CARE, PLLC

PREMIER EYE CARE, PLLC

Company Details

Name: PREMIER EYE CARE, PLLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 09 Jan 2001 (24 years ago)
Organization Date: 09 Jan 2001 (24 years ago)
Last Annual Report: 12 Feb 2025 (2 months ago)
Managed By: Members
Organization Number: 0508504
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 40391
City: Winchester, Ford
Primary County: Clark County
Principal Office: 225 HOSPITAL DRIVE, SUITE 160, WINCHESTER, KY 40391
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PREMIER EYE CARE, PLLC 401(K) PLAN 2020 611381088 2021-01-26 PREMIER EYE CARE, PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8597443937
Plan sponsor’s address 225 HOSPITAL DRIVE, SUITE 160, WINCHESTER, KY, 40391

Signature of
Role Plan administrator
Date 2021-01-26
Name of individual signing MARK W. SIMON
Valid signature Filed with authorized/valid electronic signature
PREMIER EYE CARE, PLLC 401(K) PLAN 2020 611381088 2021-06-17 PREMIER EYE CARE, PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8597443937
Plan sponsor’s address 225 HOSPITAL DRIVE, SUITE 160, WINCHESTER, KY, 40391

Signature of
Role Plan administrator
Date 2021-06-17
Name of individual signing MARK W. SIMON
Valid signature Filed with authorized/valid electronic signature
PREMIER EYE CARE, PLLC 401(K) PLAN 2019 611381088 2020-02-14 PREMIER EYE CARE, PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8597443937
Plan sponsor’s address 225 HOSPITAL DRIVE, SUITE 160, WINCHESTER, KY, 40391

Signature of
Role Plan administrator
Date 2020-02-14
Name of individual signing MARK W. SIMON
Valid signature Filed with authorized/valid electronic signature
PREMIER EYE CARE, PLLC 401(K) PLAN 2018 611381088 2019-04-07 PREMIER EYE CARE, PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8597443937
Plan sponsor’s address 225 HOSPITAL DRIVE, SUITE 160, WINCHESTER, KY, 40391

Signature of
Role Plan administrator
Date 2019-04-07
Name of individual signing MARK W. SIMON
Valid signature Filed with authorized/valid electronic signature
PREMIER EYE CARE, PLLC 401(K) PLAN 2017 611381088 2018-03-12 PREMIER EYE CARE, PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8597443937
Plan sponsor’s address 225 HOSPITAL DRIVE, SUITE 160, WINCHESTER, KY, 40391

Signature of
Role Plan administrator
Date 2018-03-12
Name of individual signing MARK W. SIMON
Valid signature Filed with authorized/valid electronic signature
PREMIER EYE CARE, PLLC 401(K) PLAN 2016 611381088 2017-03-03 PREMIER EYE CARE, PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8597443937
Plan sponsor’s address 1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391

Signature of
Role Plan administrator
Date 2017-03-03
Name of individual signing MARK W. SIMON
Valid signature Filed with authorized/valid electronic signature
PREMIER EYE CARE, PLLC 401(K) PLAN 2015 611381088 2016-03-08 PREMIER EYE CARE, PLLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8597443937
Plan sponsor’s address 1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391

Signature of
Role Plan administrator
Date 2016-03-08
Name of individual signing MARK W. SIMON
Valid signature Filed with authorized/valid electronic signature
PREMIER EYE CARE, PLLC 401(K) PLAN 2014 611381088 2015-06-02 PREMIER EYE CARE, PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8597443937
Plan sponsor’s address 1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391

Signature of
Role Plan administrator
Date 2015-06-02
Name of individual signing MARK W. SIMON
Valid signature Filed with authorized/valid electronic signature
PREMIER EYE CARE, PLLC 401(K) PLAN 2013 611381088 2014-04-07 PREMIER EYE CARE, PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8597443937
Plan sponsor’s address 1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391

Signature of
Role Plan administrator
Date 2014-04-07
Name of individual signing MARK W. SIMON
Valid signature Filed with authorized/valid electronic signature
PREMIER EYE CARE, PLLC 401(K) PLAN 2012 611381088 2013-05-14 PREMIER EYE CARE, PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8597443937
Plan sponsor’s address 1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391

Signature of
Role Plan administrator
Date 2013-05-14
Name of individual signing MARK W. SIMON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/05/29/20120529121956P030002070358001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8597443937
Plan sponsor’s address 1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391

Plan administrator’s name and address
Administrator’s EIN 611381088
Plan administrator’s name PREMIER EYE CARE, PLLC
Plan administrator’s address 1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391
Administrator’s telephone number 8597443937

Signature of
Role Plan administrator
Date 2012-05-29
Name of individual signing MARK W.SIMON
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/04/01/20110401073727P040162838448001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8597443937
Plan sponsor’s address 1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391

Plan administrator’s name and address
Administrator’s EIN 611381088
Plan administrator’s name PREMIER EYE CARE, PLLC
Plan administrator’s address 1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391
Administrator’s telephone number 8597443937

Signature of
Role Plan administrator
Date 2011-04-01
Name of individual signing MARK W. SIMON
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8597443937
Plan sponsor’s address 1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391

Plan administrator’s name and address
Administrator’s EIN 611381088
Plan administrator’s name PREMIER EYE CARE, PLLC
Plan administrator’s address 1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391
Administrator’s telephone number 8597443937

Signature of
Role Plan administrator
Date 2011-03-29
Name of individual signing MARK W. SIMON
Valid signature Filed with incorrect/unrecognized electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/07/26/20100726063241P070016966280001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2003-01-01
Business code 621111
Sponsor’s telephone number 8597443937
Plan sponsor’s address 1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391

Plan administrator’s name and address
Administrator’s EIN 611381088
Plan administrator’s name PREMIER EYE CARE, PLLC
Plan administrator’s address 1109 MCCANN DRIVE, SUITE 2, WINCHESTER, KY, 40391
Administrator’s telephone number 8597443937

Signature of
Role Plan administrator
Date 2010-07-26
Name of individual signing MARK W. SIMON
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
DR. MARK W. SIMON Registered Agent

Member

Name Role
Mark W Simon Member

Organizer

Name Role
JOHN H. ROMPF, JR. Organizer

Filings

Name File Date
Annual Report 2025-02-12
Annual Report 2024-02-28
Annual Report 2023-03-15
Annual Report 2022-03-06
Annual Report 2021-02-09
Annual Report 2020-02-24
Annual Report 2019-04-25
Annual Report 2018-04-19
Registered Agent name/address change 2017-06-14
Principal Office Address Change 2017-06-14

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
4172028306 2021-01-23 0457 PPS 225 Hospital Dr Ste 160, Winchester, KY, 40391-7635
Loan Status Date 2021-10-13
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 48400
Loan Approval Amount (current) 48400
Undisbursed Amount 0
Franchise Name -
Lender Location ID 26796
Servicing Lender Name Peoples Exchange Bank
Servicing Lender Address 101 N Main St, WINCHESTER, KY, 40391-2607
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address Winchester, CLARK, KY, 40391-7635
Project Congressional District KY-06
Number of Employees 3
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 26796
Originating Lender Name Peoples Exchange Bank
Originating Lender Address WINCHESTER, KY
Gender Male Owned
Veteran Unanswered
Forgiveness Amount 48698.47
Forgiveness Paid Date 2021-09-07
6871257002 2020-04-07 0457 PPP 225 HOSPITAL DR, #160, WINCHESTER, KY, 40391-7604
Loan Status Date 2020-12-15
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 48400
Loan Approval Amount (current) 48400
Undisbursed Amount 0
Franchise Name -
Lender Location ID 26796
Servicing Lender Name Peoples Exchange Bank
Servicing Lender Address 101 N Main St, WINCHESTER, KY, 40391-2607
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address WINCHESTER, CLARK, KY, 40391-7604
Project Congressional District KY-06
Number of Employees 6
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Not Hispanic or Latino
Business Type Limited Liability Company(LLC)
Originating Lender ID 26796
Originating Lender Name Peoples Exchange Bank
Originating Lender Address WINCHESTER, KY
Gender Male Owned
Veteran Unanswered
Forgiveness Amount 48689.26
Forgiveness Paid Date 2021-02-16

Related by officers

JOHN H. ROMPF, JR.

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Related by address

225 HOSPITAL DRIVE, SUITE 160, WINCHESTER, KY 40391

PUCKETT FAMILY EYE CARE PLLC

Sources: Kentucky Secretary of State

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