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BAHRAM FOROUZANDEH, MD, PSC

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Company Details

Name: BAHRAM FOROUZANDEH, MD, PSC
Legal type: Kentucky Professional Services Corp
Status: Inactive
Standing: Good
Profit or Non-Profit: Profit
File Date: 05 Feb 2004 (21 years ago)
Organization Date: 01 Mar 2004 (21 years ago)
Last Annual Report: 15 May 2023 (2 years ago)
Organization Number: 0578254
ZIP code: 41653
City: Prestonsburg, Emma, Endicott, Hippo
Primary County: Floyd County
Principal Office: P.O. BOX 1375, PRESTONSBURG, KY 41653
Place of Formation: KENTUCKY
Authorized Shares: 500

President

Name Role
Bahram Forouzandeh President

Shareholder

Name Role
Bahram Forouzandeh Shareholder

Registered Agent

Name Role
DR. BAHRAM FOROUZANDEH Registered Agent

Incorporator

Name Role
DR. BAHRAM FOROUZANDEH Incorporator

National Provider Identifier

NPI Number:
1295918787
Certification Date:
2020-05-19

Authorized Person:

Name:
BAHRAM FOROUZANDEH
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
207RG0100X - Gastroenterology Physician
Is Primary:
Yes

Contacts:

Fax:
6068867473

Filings

Name File Date
Dissolution 2024-02-23
Annual Report 2023-05-15
Annual Report 2022-05-16
Annual Report 2021-06-06
Annual Report 2020-03-27

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Sources: Kentucky Secretary of State