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SHEA GODWIN, M.D., P.S.C.

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Company Details

Name: SHEA GODWIN, M.D., P.S.C.
Legal type: Kentucky Professional Services Corp
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 14 Mar 2008 (17 years ago)
Organization Date: 14 Mar 2008 (17 years ago)
Last Annual Report: 04 Jul 2016 (9 years ago)
Organization Number: 0688104
ZIP code: 42211
City: Cadiz, Canton, Golden Pond
Primary County: Trigg County
Principal Office: P.O. BOX 2140, CADIZ, KY 42211
Place of Formation: KENTUCKY
Authorized Shares: 1000

CEO

Name Role
Shea Ann Godwin CEO

Director

Name Role
Shea Ann Godwin Director

Shareholder

Name Role
Shea Ann Godwin Shareholder

Incorporator

Name Role
SHEA GODWIN, M.D. Incorporator

Registered Agent

Name Role
SHEA GODWIN, M.D. Registered Agent

National Provider Identifier

NPI Number:
1881852317

Authorized Person:

Name:
SHEA A GODWIN
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
2705227231

Filings

Name File Date
Administrative Dissolution 2017-10-09
Annual Report 2016-07-04
Annual Report 2015-04-23
Annual Report 2014-02-09
Annual Report 2013-07-01

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Sources: Kentucky Secretary of State