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BULLITT COUNTY FAMILY CARE CENTER, PLLC

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Company Details

Name: BULLITT COUNTY FAMILY CARE CENTER, PLLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Bad
File Date: 15 May 2003 (22 years ago)
Organization Date: 15 May 2003 (22 years ago)
Last Annual Report: 29 Jun 2014 (11 years ago)
Managed By: Members
Organization Number: 0554138
ZIP code: 40165
City: Shepherdsville, Fox Chase, Hebron Estates, Hebron Ests, ...
Primary County: Bullitt County
Principal Office: 1578 HIGHWAY 44 EAST , SUITE 2, SHEPHERDSVILLE, KY 40165
Place of Formation: KENTUCKY

Registered Agent

Name Role
CHARLOTTE INGWERSEN, M.D. Registered Agent

Member

Name Role
CHARLOTTE INGWERSEN Member

Organizer

Name Role
CHARLOTTE INGWERSEN, M.D. Organizer

National Provider Identifier

NPI Number:
1043253925

Authorized Person:

Name:
CHARLOTTE KAY INGWERSEN
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
305R00000X - Preferred Provider Organization
Is Primary:
Yes

Contacts:

Fax:
5025435244

Filings

Name File Date
Administrative Dissolution Return 2015-10-06
Administrative Dissolution 2015-09-12
Annual Report 2014-06-29
Annual Report 2013-06-26
Annual Report 2012-06-13

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Sources: Kentucky Secretary of State