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TAYLOR COUNTY ANESTHESIA, PSC

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Company Details

Name: TAYLOR COUNTY ANESTHESIA, PSC
Legal type: Kentucky Professional Services Corp
Status: Inactive
Standing: Good
Profit or Non-Profit: Profit
File Date: 26 Feb 2001 (24 years ago)
Organization Date: 26 Feb 2001 (24 years ago)
Last Annual Report: 12 Aug 2024 (10 months ago)
Organization Number: 0511229
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 42719
City: Campbellsville, Campbellsvlle
Primary County: Taylor County
Principal Office: PO BOX 555, CAMPBELLSVILLE, KY 42719
Place of Formation: KENTUCKY
Authorized Shares: 100

Registered Agent

Name Role
GARY FRAZIER, M.D. Registered Agent

President

Name Role
GARY Manning Frazier, M.D. President

Vice President

Name Role
PAUL JOHNSON Vice President

Shareholder

Name Role
Gary Manning MOUNTAINEER GAS PSC Shareholder
Paul PAUL L. JOHNSON, D.O., PSC Shareholder

Incorporator

Name Role
GARY FRAZIER, M.D. Incorporator

National Provider Identifier

NPI Number:
1659342178

Authorized Person:

Name:
JESSICA FRAZIER
Role:
MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
367500000X - Certified Registered Nurse Anesthetist
Is Primary:
No
Selected Taxonomy:
207L00000X - Anesthesiology Physician
Is Primary:
Yes

Contacts:

Fax:
2709323674

Form 5500 Series

Employer Identification Number (EIN):
611384144
Plan Year:
2016
Number Of Participants:
2
Sponsors Telephone Number:
Plan Year:
2016
Number Of Participants:
2
Sponsors Telephone Number:
Plan Year:
2015
Number Of Participants:
2
Sponsors Telephone Number:
Plan Year:
2015
Number Of Participants:
2
Sponsors Telephone Number:
Plan Year:
2015
Number Of Participants:
2
Sponsors Telephone Number:

Filings

Name File Date
Dissolution 2024-12-19
Annual Report 2024-08-12
Principal Office Address Change 2024-08-12
Annual Report 2023-05-02
Reinstatement 2022-07-14

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Sources: Kentucky Secretary of State