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  5. KENTUCKY PAIN MANAGEMENT SERVICES, LLC

KENTUCKY PAIN MANAGEMENT SERVICES, LLC

Company Details

Name: KENTUCKY PAIN MANAGEMENT SERVICES, LLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 28 Aug 2006 (19 years ago)
Organization Date: 28 Aug 2006 (19 years ago)
Last Annual Report: 18 Feb 2025 (2 months ago)
Managed By: Members
Organization Number: 0645798
Industry: Hotels, Rooming Houses, Camps, and other Lodging Places
Number of Employees: Medium (20-99)
ZIP code: 41701
City: Hazard, Browns Fork, Typo, Walkertown
Primary County: Perry County
Principal Office: 311 ROY CAMPBELL DRIVE, HAZARD, KY 41701
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KENTUCKY PAIN MANAGEMENT SERVICES 401K PLAN 2011 205350815 2012-04-27 KENTUCKY PAIN MANAGEMENT SERVICES 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 6064871137
Plan sponsor’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486

Plan administrator’s name and address
Administrator’s EIN 205350815
Plan administrator’s name KENTUCKY PAIN MANAGEMENT SERVICES
Plan administrator’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486
Administrator’s telephone number 6064871137

Signature of
Role Plan administrator
Date 2012-04-27
Name of individual signing RANDY MULLINS
Valid signature Filed with authorized/valid electronic signature
KENTUCKY PAIN MANAGEMENT SERVICES 401K PLAN 2010 205350815 2011-07-11 KENTUCKY PAIN MANAGEMENT SERVICES 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 6064871137
Plan sponsor’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486

Plan administrator’s name and address
Administrator’s EIN 205350815
Plan administrator’s name KENTUCKY PAIN MANAGEMENT SERVICES
Plan administrator’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486
Administrator’s telephone number 6064871137

Signature of
Role Plan administrator
Date 2011-07-11
Name of individual signing RANDY MULLINS
Valid signature Filed with authorized/valid electronic signature
KENTUCKY PAIN MANAGEMENT SERVICES 401K PLAN 2009 205350815 2010-06-22 KENTUCKY PAIN MANAGEMENT SERVICES 23
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 6064871137
Plan sponsor’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486

Plan administrator’s name and address
Administrator’s EIN 205350815
Plan administrator’s name KENTUCKY PAIN MANAGEMENT SERVICES
Plan administrator’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486
Administrator’s telephone number 6064871137

Signature of
Role Plan administrator
Date 2010-06-22
Name of individual signing P. RANDY MULLINS
Valid signature Filed with incorrect/unrecognized electronic signature
KENTUCKY PAIN MANAGEMENT SERVICES 401K PLAN 2009 205350815 2010-06-23 KENTUCKY PAIN MANAGEMENT SERVICES 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 6064871137
Plan sponsor’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486

Plan administrator’s name and address
Administrator’s EIN 205350815
Plan administrator’s name KENTUCKY PAIN MANAGEMENT SERVICES
Plan administrator’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486
Administrator’s telephone number 6064871137

Signature of
Role Plan administrator
Date 2010-06-23
Name of individual signing RANDY MULLINS
Valid signature Filed with authorized/valid electronic signature
KENTUCKY PAIN MANAGEMENT SERVICES 401K PLAN 2009 205350815 2010-06-23 KENTUCKY PAIN MANAGEMENT SERVICES 23
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 6064871137
Plan sponsor’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486

Plan administrator’s name and address
Administrator’s EIN 205350815
Plan administrator’s name KENTUCKY PAIN MANAGEMENT SERVICES
Plan administrator’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486
Administrator’s telephone number 6064871137

Signature of
Role Plan administrator
Date 2010-06-23
Name of individual signing RANDY MULLINS
Valid signature Filed with incorrect/unrecognized electronic signature
KENTUCKY PAIN MANAGEMENT SERVICES 401K PLAN 2009 205350815 2010-06-23 KENTUCKY PAIN MANAGEMENT SERVICES 23
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 6064871137
Plan sponsor’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486

Plan administrator’s name and address
Administrator’s EIN 205350815
Plan administrator’s name KENTUCKY PAIN MANAGEMENT SERVICES
Plan administrator’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486
Administrator’s telephone number 6064871137

Signature of
Role Plan administrator
Date 2010-06-23
Name of individual signing RANDY MULLINS
Valid signature Filed with incorrect/unrecognized electronic signature

Organizer

Name Role
RANDY MULLINS Organizer

Registered Agent

Name Role
RANDY MULLINS Registered Agent

Member

Name Role
RANDY MULLINS Member

Filings

Name File Date
Annual Report 2025-02-18
Annual Report 2024-03-06
Annual Report 2023-03-21
Annual Report 2022-05-25
Annual Report 2021-07-08
Annual Report 2020-06-01
Annual Report 2019-06-03
Annual Report 2018-06-07
Annual Report 2017-06-20
Annual Report 2016-03-28

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3215017303 2020-04-29 0457 PPP PO BOX 1297, HAZARD, KY, 41701
Loan Status Date 2021-07-20
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 310400
Loan Approval Amount (current) 310400
Undisbursed Amount 0
Franchise Name -
Lender Location ID 27783
Servicing Lender Name Community Trust Bank, Inc.
Servicing Lender Address 346 N Mayo Trl, PIKEVILLE, KY, 41501-1847
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address HAZARD, PERRY, KY, 41701-1000
Project Congressional District KY-05
Number of Employees 23
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Limited Liability Company(LLC)
Originating Lender ID 27783
Originating Lender Name Community Trust Bank, Inc.
Originating Lender Address PIKEVILLE, KY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 313954.72
Forgiveness Paid Date 2021-06-24

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Related by address

No related companies by address

Sources: Kentucky Secretary of State

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