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  5. JACKSON PURCHASE PULMONARY MEDICINE PLLC

JACKSON PURCHASE PULMONARY MEDICINE PLLC

Company Details

Name: JACKSON PURCHASE PULMONARY MEDICINE PLLC
Jurisdiction: Kentucky
Profit or Non-Profit: Profit
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
File Date: 14 Jul 2008 (17 years ago)
Organization Date: 14 Jul 2008 (17 years ago)
Last Annual Report: 25 Jun 2024 (7 months ago)
Managed By: Managers
Organization Number: 0709380
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 42066
Primary County: Graves
Principal Office: 1111 MEDICAL CENTER CIRCLE, MAYFIELD, KY 42066
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JACKSON PURCHASE PULMONARY MEDICINE PLLC 401(K) PLAN 2023 262948840 2024-08-07 JACKSON PURCHASE PULMONARY MEDICINE 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2702514040
Plan sponsor’s address 1111 MEDICAL CENTER CIRCLE, MAYFIELD, KY, 42066
JACKSON PURCHASE PULMONARY MEDICINE PLLC 401(K) PLAN 2022 262948840 2023-08-30 JACKSON PURCHASE PULMONARY MEDICINE 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2702514040
Plan sponsor’s address 1111 MEDICAL CENTER CIRCLE, MAYFIELD, KY, 42066

Signature of
Role Plan administrator
Date 2023-08-30
Name of individual signing ROBERTO DOS REMEDIOS
Valid signature Filed with authorized/valid electronic signature
JACKSON PURCHASE PULMONARY MEDICINE PLLC 401(K) PLAN 2021 262948840 2022-08-08 JACKSON PURCHASE PULMONARY MEDICINE 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2702514040
Plan sponsor’s address 1111 MEDICAL CENTER CIRCLE, MAYFIELD, KY, 42066

Signature of
Role Plan administrator
Date 2022-08-08
Name of individual signing ROBERTO DOS REMEDIOS
Valid signature Filed with authorized/valid electronic signature
JACKSON PURCHASE PULMONARY MEDICINE PLLC 401(K) PLAN 2020 262948840 2021-07-20 JACKSON PURCHASE PULMONARY MEDICINE 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2702514040
Plan sponsor’s address 1111 MEDICAL CENTER CIRCLE, MAYFIELD, KY, 42066

Signature of
Role Plan administrator
Date 2021-07-20
Name of individual signing ROBERTO DOS REMEDIOS
Valid signature Filed with authorized/valid electronic signature
JACKSON PURCHASE PULMONARY MEDICINE PLLC 401(K) PLAN 2019 262948840 2020-09-20 JACKSON PURCHASE PULMONARY MEDICINE 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2702514040
Plan sponsor’s address 1111 MEDICAL CENTER CIRCLE, MAYFIELD, KY, 42066

Signature of
Role Plan administrator
Date 2020-09-20
Name of individual signing ROBERTO DOS REMEDIOS
Valid signature Filed with authorized/valid electronic signature
JACKSON PURCHASE PULMONARY MEDICINE PLLC 401(K) PLAN 2018 262948840 2019-10-04 JACKSON PURCHASE PULMONARY MEDICINE 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2702514040
Plan sponsor’s address 1111 MEDICAL CENTER CIRCLE, MAYFIELD, KY, 42066

Signature of
Role Plan administrator
Date 2019-10-04
Name of individual signing ROBERTO DOS REMEDIOS
Valid signature Filed with authorized/valid electronic signature
JACKSON PURCHASE PULMONARY MEDICINE PLLC 401(K) PLAN 2017 262948840 2018-08-26 JACKSON PURCHASE PULMONARY MEDICINE 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2702514040
Plan sponsor’s address 1111 MEDICAL CENTER CIRCLE, MAYFIELD, KY, 42066

Signature of
Role Plan administrator
Date 2018-08-26
Name of individual signing ROBERTO DOS REMEDIOS
Valid signature Filed with authorized/valid electronic signature
JACKSON PURCHASE PULMONARY MEDICINE PLLC 401(K) PLAN 2016 262948840 2020-09-20 JACKSON PURCHASE PULMONARY MEDICINE 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2702514040
Plan sponsor’s address 1111 MEDICAL CENTER CIRCLE, MAYFIELD, KY, 42066

Signature of
Role Plan administrator
Date 2020-09-20
Name of individual signing ROBERTO DOS REMEDIOS
Valid signature Filed with authorized/valid electronic signature
JACKSON PURCHASE PULMONARY MEDICINE PLLC 401(K) PLAN 2016 273317776 2017-09-19 JACKSON PURCHASE PULMONARY MEDICINE 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2702514040
Plan sponsor’s address 1111 MEDICAL CENTER CIRCLE, MAYFIELD, KY, 42066

Signature of
Role Plan administrator
Date 2017-09-19
Name of individual signing ROBERTO DOS REMEDIOS
Valid signature Filed with authorized/valid electronic signature
JACKSON PURCHASE PULMONARY MEDICINE PLLC 401(K) PLAN 2015 273317776 2016-09-27 JACKSON PURCHASE PULMONARY MEDICINE 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2702514040
Plan sponsor’s address 1111 MEDICAL CENTER CIRCLE, MAYFIELD, KY, 42066
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/05/18/20150518125919P030002693927001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2702514040
Plan sponsor’s address 1111 MEDICAL CENTER CIRCLE, MAYFIELD, KY, 42066
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/10/01/20141001145027P030010686509001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2702514040
Plan sponsor’s address 1111 MEDICAL CENTER CIRCLE, MAYFIELD, KY, 42066
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/06/20/20130620131351P040093650709001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2702514040
Plan sponsor’s address 1111 MEDICAL CENTER CIRCLE, MAYFIELD, KY, 42066

Signature of
Role Plan administrator
Date 2013-06-20
Name of individual signing ROBERTO DOS REMEDIOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-06-20
Name of individual signing ROBERTO DOS REMEDIOS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/09/10/20120910124627P030005513108001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2702514040
Plan sponsor’s address 1111 MEDICAL CENTER CIRCLE, MAYFIELD, KY, 42066

Plan administrator’s name and address
Administrator’s EIN 262948840
Plan administrator’s name JACKSON PURCHASE PULMONARY MEDICINE, PLLC
Plan administrator’s address 1111 MEDICAL CENTER CIRCLE, MAYFIELD, KY, 42066
Administrator’s telephone number 2702514040

Signature of
Role Plan administrator
Date 2012-09-10
Name of individual signing ROBERTO DOS REMEDIOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-09-10
Name of individual signing ROBERTO DOS REMEDIOS
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/09/07/20110907114444P030587645408001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2010-01-01
Business code 621111
Sponsor’s telephone number 2702514040
Plan sponsor’s address 1111 MEDICAL CENTER CIRCLE, MAYFIELD, KY, 42066

Plan administrator’s name and address
Administrator’s EIN 262948840
Plan administrator’s name JACKSON PURCHASE PULMONARY MEDICINE, PLLC
Plan administrator’s address 1111 MEDICAL CENTER CIRCLE, MAYFIELD, KY, 42066
Administrator’s telephone number 2702514040

Signature of
Role Plan administrator
Date 2011-09-07
Name of individual signing ROBERTO DOS REMEDIOS
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-09-07
Name of individual signing ROBERTO DOS REMEDIOS
Valid signature Filed with authorized/valid electronic signature

Manager

Name Role
Roberto Dos Remedios Manager

Organizer

Name Role
ROBERTO DOS REMEDIOS Organizer

Registered Agent

Name Role
ROBERTO DOS REMEDIOS Registered Agent

Filings

Name File Date
Annual Report 2024-06-25
Annual Report 2023-06-05
Registered Agent name/address change 2022-06-22
Annual Report 2022-06-22
Annual Report 2021-06-30
Annual Report 2020-05-26
Annual Report 2019-06-25
Annual Report 2018-06-11
Annual Report 2017-06-12
Annual Report 2016-06-13

Related by officers

No related officers

Related by address

1111 MEDICAL CENTER CIRCLE, MAYFIELD, KY 42066

MORGAN-HAUGH PROFESSIONAL SERVICE CORPORATION ALAN L. CHRISTENSEN, M.D., PSC JACKSON PURCHASE PEDIATRICS PLLC

Date of last update: 16 Jan 2025

Sources: Kentucky Secretary of State

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