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TRI-STATE VASCULAR GROUP, PSC

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Company Details

Name: TRI-STATE VASCULAR GROUP, PSC
Legal type: Kentucky Professional Services Corp
Status: Inactive
Standing: Good
Profit or Non-Profit: Profit
File Date: 15 Dec 2005 (19 years ago)
Organization Date: 15 Dec 2005 (19 years ago)
Last Annual Report: 01 Feb 2012 (13 years ago)
Organization Number: 0627706
ZIP code: 41101
City: Ashland, Summitt, Westwood
Primary County: Boyd County
Principal Office: 2301 LEXINGTON AVENUE , SUITE 230, ASHLAND, KY 41101
Place of Formation: KENTUCKY
Authorized Shares: 100

Director

Name Role
OMRAN ABUL KHOUDOUD Director

Registered Agent

Name Role
OMRAN ABUL KHOUDOUD Registered Agent

President

Name Role
OMRAN ABUL KHOUDOUD President

Signature

Name Role
OMRAN ABUL KHOUDOUD Signature

Shareholder

Name Role
OMRAN ABUL KHOUDOUD Shareholder

Incorporator

Name Role
OMRAN ABUL-KHOUDOUD, MD Incorporator

National Provider Identifier

NPI Number:
1649217910

Authorized Person:

Name:
DR. OMRAN RIAD ABUL-KHOUDOUD
Role:
PRESIDENT/VASCULAR SURGEON
Phone:

Taxonomy:

Selected Taxonomy:
174400000X - Specialist
Is Primary:
Yes

Contacts:

Fax:
6063261436

Form 5500 Series

Employer Identification Number (EIN):
203981871
Plan Year:
2012
Number Of Participants:
10
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
10
Sponsors Telephone Number:
Plan Year:
2011
Number Of Participants:
11
Sponsors Telephone Number:
Plan Year:
2010
Number Of Participants:
11
Sponsors Telephone Number:
Plan Year:
2009
Number Of Participants:
9
Sponsors Telephone Number:

Filings

Name File Date
Dissolution 2012-12-28
Annual Report 2012-02-01
Annual Report 2011-04-14
Annual Report 2010-04-26
Reinstatement 2009-04-14

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Sources: Kentucky Secretary of State