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BLUEGRASS GENERAL SURGERY, LLC

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Company Details

Name: BLUEGRASS GENERAL SURGERY, LLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 09 May 2005 (20 years ago)
Organization Date: 09 May 2005 (20 years ago)
Last Annual Report: 04 Mar 2013 (12 years ago)
Managed By: Members
Organization Number: 0612590
ZIP code: 40004
City: Bardstown
Primary County: Nelson County
Principal Office: 201 SOUTH FIFTH STREET, SUITE 10, BARDSTOWN, KY 40004
Place of Formation: KENTUCKY

Registered Agent

Name Role
DAVID M. FABER Registered Agent

Member

Name Role
David M Faber Member

Organizer

Name Role
DAVID M. FABER Organizer

National Provider Identifier

NPI Number:
1871646539

Authorized Person:

Name:
MISS DAVID M FABER
Role:
OFFICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
208600000X - Surgery Physician
Is Primary:
Yes

Contacts:

Fax:
5023485898

Filings

Name File Date
Administrative Dissolution Return 2014-11-20
Administrative Dissolution 2014-09-30
Principal Office Address Change 2013-03-04
Annual Report 2013-03-04
Registered Agent name/address change 2012-12-19

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Sources: Kentucky Secretary of State