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EASTERN KENTUCKY PAIN MANAGEMENT CENTER, LLC

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Company Details

Name: EASTERN KENTUCKY PAIN MANAGEMENT CENTER, LLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 29 Sep 2009 (16 years ago)
Organization Date: 29 Sep 2009 (16 years ago)
Last Annual Report: 14 Jan 2011 (14 years ago)
Managed By: Members
Organization Number: 0744712
ZIP code: 40475
City: Richmond
Primary County: Madison County
Principal Office: 124 NORTHGATE DR., RICHMOND, KY 40475
Place of Formation: KENTUCKY

Registered Agent

Name Role
JUSTIN WADE Registered Agent

Member

Name Role
BRAD HAMDEN Member

Organizer

Name Role
JANSON WADE Organizer
BRAD HAMBLEN Organizer

National Provider Identifier

NPI Number:
1053647313

Authorized Person:

Name:
BRAD HAMBLEN
Role:
MEMBER
Phone:

Taxonomy:

Selected Taxonomy:
332B00000X - Durable Medical Equipment & Medical Supplies
Is Primary:
No
Selected Taxonomy:
363A00000X - Physician Assistant
Is Primary:
No
Selected Taxonomy:
208100000X - Physical Medicine & Rehabilitation Physician
Is Primary:
Yes

Contacts:

Fax:
8596267766

Filings

Name File Date
Administrative Dissolution Return 2012-09-26
Administrative Dissolution 2012-09-11
Registered Agent name/address change 2012-05-18
Registered Agent name/address change 2011-01-14
Annual Report 2011-01-14

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Sources: Kentucky Secretary of State