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  5. CLARK COUNTY PHARMACY, INC.

CLARK COUNTY PHARMACY, INC.

Company Details

Name: CLARK COUNTY PHARMACY, INC.
Legal type: Kentucky Corporation
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
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
City: Winchester, Ford
Primary County: Clark County
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

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

Incorporator

Name Role
NEVIN S. GOEBEL Incorporator

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

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
5779687005 2020-04-06 0457 PPP 716 Boone Ave, WINCHESTER, KY, 40391-2370
Loan Status Date 2021-02-05
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 100400
Loan Approval Amount (current) 100400
Undisbursed Amount 0
Franchise Name -
Lender Location ID 27631
Servicing Lender Name Traditional Bank, Inc.
Servicing Lender Address 49 W Main St, MOUNT STERLING, KY, 40353-1316
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address WINCHESTER, CLARK, KY, 40391-2370
Project Congressional District KY-06
Number of Employees 10
NAICS code 446110
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 27631
Originating Lender Name Traditional Bank, Inc.
Originating Lender Address MOUNT STERLING, KY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 101134.43
Forgiveness Paid Date 2021-01-08

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Related by address

No related companies by address

Sources: Kentucky Secretary of State

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