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BLUEGRASS MEDICAL CLINIC, PLLC

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Company Details

Name: BLUEGRASS MEDICAL CLINIC, PLLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Good
Profit or Non-Profit: Profit
File Date: 21 Sep 2001 (24 years ago)
Organization Date: 21 Sep 2001 (24 years ago)
Last Annual Report: 14 Apr 2015 (10 years ago)
Managed By: Members
Organization Number: 0522836
ZIP code: 40361
City: Paris
Primary County: Bourbon County
Principal Office: 1035 CYNTHIANA ROAD, PARIS, KY 40361
Place of Formation: KENTUCKY

Registered Agent

Name Role
NATHAN L. MOORE Registered Agent

Member

Name Role
C Ray Young Jr Member
Nathan L Moore Member

Signature

Name Role
NATHAN L MOORE Signature
C RAY YOUNG JR. Signature

Organizer

Name Role
WILLIAM H. ENGLE, SR. Organizer

National Provider Identifier

NPI Number:
1902910722

Authorized Person:

Name:
NATHAN L MOORE
Role:
PARTNER BLUEGRASS MEDICAL CLINIC PL
Phone:

Taxonomy:

Selected Taxonomy:
363A00000X - Physician Assistant
Is Primary:
No
Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
8599870098

Form 5500 Series

Employer Identification Number (EIN):
610990080
Plan Year:
2015
Number Of Participants:
11
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
11
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
12
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
17
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
17
Sponsors Telephone Number:

Filings

Name File Date
Dissolution 2015-12-29
Annual Report 2015-04-14
Principal Office Address Change 2015-02-05
Registered Agent name/address change 2015-02-05
Annual Report 2014-03-27

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Sources: Kentucky Secretary of State