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PROFESSIONAL PEDIATRICS, PSC

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Company Details

Name: PROFESSIONAL PEDIATRICS, PSC
Legal type: Kentucky Professional Services Corp
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 17 Dec 2001 (23 years ago)
Organization Date: 17 Dec 2001 (23 years ago)
Last Annual Report: 30 Jun 2013 (12 years ago)
Organization Number: 0527293
ZIP code: 41169
City: Russell, Raceland
Primary County: Greenup County
Principal Office: C/O SUSAN LICHTENBERGER, MD, 105 THOMPSON ROAD, RUSSELL, KY 41169
Place of Formation: KENTUCKY
Authorized Shares: 1000

Registered Agent

Name Role
SUSAN LICHTENBERGER, MD Registered Agent

President

Name Role
Susan M. Lichtenberger President

Director

Name Role
Susan M. Lichtenberger Director

Shareholder

Name Role
Susan M. Lichtenberger Shareholder

Incorporator

Name Role
DEBORA HOLLAND TUDOR Incorporator

National Provider Identifier

NPI Number:
1083819304

Authorized Person:

Name:
DR. SUSAN M. LICHTENBERGER
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
208000000X - Pediatrics Physician
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
611401681
Plan Year:
2012
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2010
Number Of Participants:
4
Sponsors Telephone Number:
Plan Year:
2009
Number Of Participants:
4
Sponsors Telephone Number:

Filings

Name File Date
Administrative Dissolution Return 2014-10-23
Administrative Dissolution 2014-09-30
Annual Report 2013-06-30
Annual Report 2012-06-22
Annual Report 2011-06-11

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Sources: Kentucky Secretary of State