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  5. CLARK COUNTY PHARMACY, INC.

CLARK COUNTY PHARMACY, INC.

Company Details

Name: CLARK COUNTY PHARMACY, INC.
Jurisdiction: Kentucky
Profit or Non-Profit: Profit
Legal type: Kentucky Corporation
Status: Inactive
Standing: Bad
File Date: 12 Apr 2004 (21 years ago)
Organization Date: 12 Apr 2004 (21 years ago)
Last Annual Report: 22 Jun 2021 (4 years ago)
Organization Number: 0583489
ZIP code: 40391
Primary County: Clark
Principal Office: 716 BOONE AVENUE, WINCHESTER, KY 40391
Place of Formation: KENTUCKY
Authorized Shares: 1000

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
CLARK COUNTY PHARMACY, INC. 401(K) PLAN 2020 611470458 2021-05-06 CLARK COUNTY PHARMACY, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-06-30
Business code 446110
Sponsor’s telephone number 8597443350
Plan sponsor’s address 716 BOONE AVE., WINCHESTER, KY, 40391

Signature of
Role Plan administrator
Date 2021-05-06
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature
CLARK COUNTY PHARMACY, INC. 401(K) PLAN 2020 611470458 2021-12-07 CLARK COUNTY PHARMACY INC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-06-30
Business code 446110
Sponsor’s telephone number 8597443350
Plan sponsor’s address 709 S. MAPLE ST., WINCHESTER, KY, 40391

Signature of
Role Plan administrator
Date 2021-12-07
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature
CLARK COUNTY PHARMACY, INC. 401(K) PLAN 2019 611470458 2020-05-12 CLARK COUNTY PHARMACY, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-06-30
Business code 446110
Sponsor’s telephone number 8597443350
Plan sponsor’s address 716 BOONE AVE., WINCHESTER, KY, 40391

Signature of
Role Plan administrator
Date 2020-05-12
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature
CLARK COUNTY PHARMACY, INC. 401(K) PLAN 2018 611470458 2019-05-27 CLARK COUNTY PHARMACY, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-06-30
Business code 446110
Sponsor’s telephone number 8597443350
Plan sponsor’s address 716 BOONE AVE., WINCHESTER, KY, 40391

Signature of
Role Plan administrator
Date 2019-05-27
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature
CLARK COUNTY PHARMACY, INC. 401(K) PLAN 2017 611470458 2018-05-05 CLARK COUNTY PHARMACY, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-15
Business code 446110
Sponsor’s telephone number 8597443350
Plan sponsor’s address 716 BOONE AVE., WINCHESTER, KY, 40391

Signature of
Role Plan administrator
Date 2018-05-05
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature
CLARK COUNTY PHARMACY INC 401(K) PLAN 2016 611470458 2017-03-15 CLARK COUNTY PHARMACY INC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-15
Business code 446110
Sponsor’s telephone number 8597443350
Plan sponsor’s address 1520B BOONESBORO RD, WINCHESTER, KY, 403918816

Signature of
Role Plan administrator
Date 2017-03-15
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature
CLARK COUNTY PHARMACY INC 401(K) PLAN 2015 611470458 2016-06-21 CLARK COUNTY PHARMACY INC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-15
Business code 446110
Sponsor’s telephone number 8597443350
Plan sponsor’s address 1520B BOONESBORO RD, WINCHESTER, KY, 403918816

Signature of
Role Plan administrator
Date 2016-06-21
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-06-21
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature
CLARK COUNTY PHARMACY INC 401K PLAN 2014 611470458 2015-06-27 CLARK COUNTY PHARMACY INC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-15
Business code 446110
Sponsor’s telephone number 8597443350
Plan sponsor’s address 1520B BOONESBORO RD, WINCHESTER, KY, 403918816

Signature of
Role Plan administrator
Date 2015-06-27
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-06-27
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature
CLARK COUNTY PHARMACY INC 401K PLAN 2013 611470458 2014-05-26 CLARK COUNTY PHARMACY INC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-15
Business code 446110
Sponsor’s telephone number 8597443350
Plan sponsor’s address 1520B BOONESBORO RD, WINCHESTER, KY, 403918816

Signature of
Role Plan administrator
Date 2014-05-26
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-05-26
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature
CLARK COUNTY PHARMACY INC 401K PLAN 2012 611470458 2013-06-07 CLARK COUNTY PHARMACY INC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-07-15
Business code 446110
Sponsor’s telephone number 8597443350
Plan sponsor’s address 1520B BOONESBORO RD, WINCHESTER, KY, 403918816

Signature of
Role Plan administrator
Date 2013-06-07
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-06-07
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/06/02/20120602064032P030001152727001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2006-07-15
Business code 446110
Sponsor’s telephone number 8597443350
Plan sponsor’s address 1520B BOONESBORO RD, WINCHESTER, KY, 403918816

Plan administrator’s name and address
Administrator’s EIN 611470458
Plan administrator’s name CLARK COUNTY PHARMACY INC
Plan administrator’s address 1520B BOONESBORO RD, WINCHESTER, KY, 403918816
Administrator’s telephone number 8597443350

Signature of
Role Plan administrator
Date 2012-06-02
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-06-02
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2006-07-15
Business code 446110
Sponsor’s telephone number 8597443350
Plan sponsor’s address 1520B BOONESBORO RD, WINCHESTER, KY, 403918816

Plan administrator’s name and address
Administrator’s EIN 611470458
Plan administrator’s name CLARK COUNTY PHARMACY INC
Plan administrator’s address 1520B BOONESBORO RD, WINCHESTER, KY, 403918816
Administrator’s telephone number 8597443350

Signature of
Role Plan administrator
Date 2011-07-05
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-05
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/11/20/20111120145633P040008427729001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2006-07-15
Business code 446110
Sponsor’s telephone number 8597443350
Plan sponsor’s address 1520B BOONESBORO RD, WINCHESTER, KY, 403918816

Plan administrator’s name and address
Administrator’s EIN 611470458
Plan administrator’s name CLARK COUNTY PHARMACY INC
Plan administrator’s address 1520B BOONESBORO RD, WINCHESTER, KY, 403918816
Administrator’s telephone number 8597443350

Signature of
Role Plan administrator
Date 2011-11-20
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-11-20
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/08/31/20100831135058P030160109298001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2006-07-15
Business code 446110
Sponsor’s telephone number 8597443350
Plan sponsor’s address 1520B BOONESBORO RD, WINCHESTER, KY, 403918816

Plan administrator’s name and address
Administrator’s EIN 611470458
Plan administrator’s name CLARK COUNTY PHARMACY INC
Plan administrator’s address 1520B BOONESBORO RD, WINCHESTER, KY, 403918816
Administrator’s telephone number 8597443350

Signature of
Role Plan administrator
Date 2010-08-31
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-08-31
Name of individual signing NEVIN GOEBEL
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
NEVIN S. GOEBEL Registered Agent

Incorporator

Name Role
NEVIN S. GOEBEL Incorporator

President

Name Role
NEVIN S GOEBEL President

Vice President

Name Role
TRACEY R GOEBEL Vice President

Director

Name Role
NEVIN S GOEBEL Director
TRACEY R GOEBEL Director

Filings

Name File Date
Administrative Dissolution 2022-10-04
Annual Report 2021-06-22
Annual Report 2020-06-17
Annual Report 2019-06-17
Annual Report 2018-06-19
Principal Office Address Change 2017-05-08
Annual Report 2017-05-08
Registered Agent name/address change 2016-06-22
Annual Report 2016-06-22
Annual Report 2015-05-12

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TRACEY R GOEBEL

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Related by address

No related companies by address

Date of last update: 31 Dec 2024

Sources: Kentucky Secretary of State

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