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MEDICAL IMAGING SHELBYVILLE, LLC

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Company Details

Name: MEDICAL IMAGING SHELBYVILLE, LLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 21 Feb 2006 (19 years ago)
Organization Date: 21 Feb 2006 (19 years ago)
Last Annual Report: 25 Jun 2010 (15 years ago)
Managed By: Managers
Organization Number: 0632774
ZIP code: 40031
City: La Grange, Lagrange
Primary County: Oldham County
Principal Office: 120 EAST ADAMS STREET, LAGRANGE, KY 40031
Place of Formation: KENTUCKY

Organizer

Name Role
JANNICE O. AARON, M.D. Organizer

Registered Agent

Name Role
DAVID WALLACE, MD Registered Agent

Manager

Name Role
David Wallace MD Manager

National Provider Identifier

NPI Number:
1548591266

Authorized Person:

Name:
DR. DAVID W WALLACE
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
2085B0100X - Body Imaging Physician
Is Primary:
Yes

Contacts:

Fax:
5026476011

Filings

Name File Date
Administrative Dissolution 2011-09-10
Annual Report 2010-06-25
Registered Agent name/address change 2009-07-30
Annual Report 2009-07-14
Annual Report 2008-06-30

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Sources: Kentucky Secretary of State