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BLUEGRASS NEUROLOGICAL SERVICES, P.S.C.

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Company Details

Name: BLUEGRASS NEUROLOGICAL SERVICES, P.S.C.
Legal type: Kentucky Professional Services Corp
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 05 Jun 2003 (22 years ago)
Organization Date: 05 Jun 2003 (22 years ago)
Last Annual Report: 10 Jun 2010 (15 years ago)
Organization Number: 0561441
ZIP code: 40422
City: Danville
Primary County: Boyle County
Principal Office: 990 W. COUNT FLEET CIRCLE, DANVILLE, KY 40422
Place of Formation: KENTUCKY
Authorized Shares: 1000

Registered Agent

Name Role
THOMAS W JOHNSON JR MD Registered Agent

President

Name Role
Thomas W. Johnson, Jr., M.D. President

Shareholder

Name Role
Thomas W. Johnson, Jr., M.D. Shareholder

Signature

Name Role
THOMAS W JOHNSON JR Signature
THOMAS W. JOHNSON Signature

Incorporator

Name Role
THOMAS W JOHNSON JR MD Incorporator

National Provider Identifier

NPI Number:
1356447866

Authorized Person:

Name:
THOMAS W JOHNSON JR.
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
2084N0400X - Neurology Physician
Is Primary:
Yes

Contacts:

Fax:
3175672191
Fax:
8599360095

Form 5500 Series

Employer Identification Number (EIN):
161673385
Plan Year:
2010
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2010
Number Of Participants:
3
Sponsors Telephone Number:
Plan Year:
2009
Number Of Participants:
4
Sponsors Telephone Number:

Filings

Name File Date
Administrative Dissolution 2011-09-10
Principal Office Address Change 2011-02-22
Annual Report 2010-06-10
Annual Report 2009-06-03
Principal Office Address Change 2008-06-11

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Sources: Kentucky Secretary of State