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Avicenna Pain Relief, PLLC

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Company Details

Name: Avicenna Pain Relief, PLLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 09 Jun 2010 (15 years ago)
Organization Date: 09 Jun 2010 (15 years ago)
Last Annual Report: 21 May 2015 (10 years ago)
Managed By: Members
Organization Number: 0764738
ZIP code: 42701
City: Elizabethtown, E Town
Primary County: Hardin County
Principal Office: 3044 RING ROAD EAST, ELIZABETHTOWN, KY 42701
Place of Formation: KENTUCKY

Manager

Name Role
Premlata Dhyani Manager
Yunus Muneer Shah Manager

Registered Agent

Name Role
Yunus Muneer Shah Registered Agent

Organizer

Name Role
Premlata Dhyani Organizer

National Provider Identifier

NPI Number:
1982906855

Authorized Person:

Name:
YUNUS SHAH
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207L00000X - Anesthesiology Physician
Is Primary:
No
Selected Taxonomy:
208VP0000X - Pain Medicine Physician
Is Primary:
Yes

Contacts:

Fax:
2709822717

Filings

Name File Date
Administrative Dissolution 2016-10-01
Annual Report 2015-05-21
Amendment 2014-12-09
Annual Report 2014-02-09
Annual Report 2013-06-25

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Sources: Kentucky Secretary of State