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MADISON COUNTY CLINIC, PLLC

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Company Details

Name: MADISON COUNTY CLINIC, PLLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 03 Nov 2010 (15 years ago)
Organization Date: 03 Nov 2010 (15 years ago)
Last Annual Report: 17 Feb 2012 (13 years ago)
Managed By: Members
Organization Number: 0774725
ZIP code: 40513
City: Lexington
Primary County: Fayette County
Principal Office: 2212 CARRINGTON COURT, LEXINGTON, KY 40513
Place of Formation: KENTUCKY

Registered Agent

Name Role
SYED S. SHAH, MD Registered Agent

Member

Name Role
SYED SHAH Member

Organizer

Name Role
SYED S. SHAH, MD Organizer

National Provider Identifier

NPI Number:
1720389430

Authorized Person:

Name:
SYED SHAH
Role:
PHYSICIAN
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QR1300X - Rural Health Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
8596240071

Filings

Name File Date
Administrative Dissolution 2013-09-28
Annual Report 2012-02-17
Annual Report 2011-04-05
Articles of Organization (LLC) 2010-11-03

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Sources: Kentucky Secretary of State