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Green Valley Rural Clinics, LLC

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Company Details

Name: Green Valley Rural Clinics, LLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 17 Feb 2010 (16 years ago)
Organization Date: 17 Feb 2010 (16 years ago)
Managed By: Managers
Organization Number: 0756753
ZIP code: 41501
City: Pikeville, Broad Bottom, Gulnare, Mccombs, Meta, Ne...
Primary County: Pike County
Principal Office: 156 Island Creek Road, Pikeville, KY 41501
Place of Formation: KENTUCKY

Organizer

Name Role
Djien Hwat So Organizer

Registered Agent

Name Role
Djien Hwat So Registered Agent

National Provider Identifier

NPI Number:
1962602821

Authorized Person:

Name:
MR. DJIEN H. SO
Role:
ADMINISTRATOR
Phone:

Taxonomy:

Selected Taxonomy:
207K00000X - Allergy & Immunology Physician
Is Primary:
No
Selected Taxonomy:
207RG0300X - Geriatric Medicine (Internal Medicine) Physician
Is Primary:
No
Selected Taxonomy:
363A00000X - Physician Assistant
Is Primary:
No
Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
Yes

Contacts:

Fax:
6064370438

Filings

Name File Date
Administrative Dissolution 2011-09-10

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Sources: Kentucky Secretary of State