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BUFFALO TRACE GASTROENTEROLOGY PLLC

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Company Details

Name: BUFFALO TRACE GASTROENTEROLOGY PLLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Bad
File Date: 24 Jul 2006 (19 years ago)
Organization Date: 24 Jul 2006 (19 years ago)
Last Annual Report: 10 Feb 2021 (4 years ago)
Managed By: Members
Organization Number: 0643385
ZIP code: 41056
City: Maysville, Sardis
Primary County: Mason County
Principal Office: MEADOWVIEW PHYSICIAN PRACTICE, LLC, DBA BUFFALO TRACE GATSROENTEROLOGY, 991 MEDICAL PARK DRIVE, SUITE 203, MAYSVILLE, KY 41056
Place of Formation: KENTUCKY

Registered Agent

Name Role
U-B OF KENTUCKY CORPORATION Registered Agent

Member

Name Role
Donald A Weller Member

Organizer

Name Role
U-B OF KENTUCKY CORPORATION Organizer

National Provider Identifier

NPI Number:
1508971722

Authorized Person:

Name:
MS. KAMI JARRELLS
Role:
PRACTICE MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
207RG0100X - Gastroenterology Physician
Is Primary:
Yes

Contacts:

Fax:
6067595582

Form 5500 Series

Employer Identification Number (EIN):
205289291
Plan Year:
2015
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2014
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2013
Number Of Participants:
5
Sponsors Telephone Number:
Plan Year:
2012
Number Of Participants:
5
Sponsors Telephone Number:

Filings

Name File Date
Administrative Dissolution 2022-10-04
Annual Report 2021-02-10
Annual Report 2020-06-02
Annual Report 2019-06-30
Registered Agent name/address change 2018-02-02

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Sources: Kentucky Secretary of State