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  5. PENNYROYAL HEALTHCARE SERVICES, INC.

PENNYROYAL HEALTHCARE SERVICES, INC.

Company Details

Name: PENNYROYAL HEALTHCARE SERVICES, INC.
Legal type: Kentucky Corporation
Status: Active
Standing: Good
Profit or Non-Profit: Non-profit
File Date: 10 Nov 2010 (14 years ago)
Organization Date: 10 Nov 2010 (14 years ago)
Last Annual Report: 22 May 2024 (a year ago)
Organization Number: 0775273
Industry: Health Services
Number of Employees: Medium (20-99)
ZIP code: 42445
City: Princeton
Primary County: Caldwell County
Principal Office: 402 NORTH JEFFERSON STREET, P.O. BOX 151, PRINCETON, KY 42445
Place of Formation: KENTUCKY

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
XPL4K5F58UK5 2025-04-15 402 N JEFFERSON ST, PRINCETON, KY, 42445, 1553, USA PO BOX 151, PRINCETON, KY, 42445, USA

Business Information
Doing Business As PENNYROYAL HEALTH CARE SERVICES
Congressional District 01
State/Country of Incorporation KY, USA
Activation Date 2024-04-17
Initial Registration Date 2010-11-08
Entity Start Date 2010-10-01
Fiscal Year End Close Date Sep 30

Service Classifications
NAICS Codes 621210, 621330, 621420, 621498

Points of Contacts
Electronic Business
Title PRIMARY POC
Name STARLA CUMMINGS
Role CFO
Address 402 NORTH JEFFERSON STREET, PRINCETON, KY, 42445, USA
Title ALTERNATE POC
Name KECIA FULCHER
Address 310 HAWTHORNE STREET, PO BOX 151, PRINCETON, KY, 42445, USA
Government Business
Title PRIMARY POC
Name STARLA CUMMINGS
Role CFO
Address 402 NORTH JEFFERSON STREET, PRINCETON, KY, 42445, USA
Title ALTERNATE POC
Name STARLA CUMMINGS
Role ACCOUNTING MANAGER
Address 310 HAWTHORNE STREET, PO BOX 151, PRINCETON, KY, 42445, USA
Past Performance
Title PRIMARY POC
Name STARLA CUMMINGS
Role CFO
Address 402 NORTH JEFFERSON STREET, PRINCETON, KY, 42445, USA
Title ALTERNATE POC
Name STARLA CUMMINGS
Role CFO
Address 402 NORTH JEFFERSON STREET, PRINCETON, KY, 42445, USA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
403(B) THRIFT PLAN OF PENNYROYAL HEALTH CARE SERVICES, INC. 2023 273618164 2024-01-22 PENNYROYAL HEALTH CARE SERVICES, INC. 65
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2706326741
Plan sponsor’s address 310 HAWTHORNE STREET, PRINCETON, KY, 424451522

Signature of
Role Plan administrator
Date 2024-01-22
Name of individual signing LINDA SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2024-01-22
Name of individual signing LINDA SMITH
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF PENNYROYAL HEALTH CARE SERVICES, INC. 2022 273618164 2023-03-01 PENNYROYAL HEALTH CARE SERVICES, INC. 60
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2706326741
Plan sponsor’s address 310 HAWTHORNE STREET, PRINCETON, KY, 424451522

Signature of
Role Plan administrator
Date 2023-03-01
Name of individual signing LINDA F. SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2023-03-01
Name of individual signing LINDA F. SMITH
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF PENNYROYAL HEALTH CARE SERVICES, INC. 2021 273618164 2022-05-04 PENNYROYAL HEALTH CARE SERVICES, INC. 57
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2706326741
Plan sponsor’s address 310 HAWTHORNE ST., PRINCETON, KY, 424451522

Signature of
Role Plan administrator
Date 2022-05-04
Name of individual signing LINDA SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2022-05-04
Name of individual signing LINDA SMITH
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF PENNYROYAL HEALTH CARE SERVICES, INC. 2020 273618164 2021-02-22 PENNYROYAL HEALTH CARE SERVICES, INC. 50
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2706326741
Plan sponsor’s address 310 HAWTHORNE ST., PRINCETON, KY, 424451522

Signature of
Role Plan administrator
Date 2021-02-22
Name of individual signing LINDA SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2021-02-22
Name of individual signing LINDA SMITH
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF PENNYROYAL HEALTH CARE SERVICES, INC. 2019 273618164 2020-02-04 PENNYROYAL HEALTH CARE SERVICES, INC. 43
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2706326741
Plan sponsor’s address 310 HAWTHORNE ST., PRINCETON, KY, 424451522

Signature of
Role Plan administrator
Date 2020-02-04
Name of individual signing LINDA F. SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2020-02-04
Name of individual signing LINDA F. SMITH
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF PENNYROYAL HEALTH CARE SERVICES, INC. 2018 273618164 2019-02-04 PENNYROYAL HEALTH CARE SERVICES, INC. 37
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2706326741
Plan sponsor’s address 310 HAWTHORNE ST., PRINCETON, KY, 424451522

Signature of
Role Plan administrator
Date 2019-02-04
Name of individual signing LINDA SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2019-02-04
Name of individual signing LINDA SMITH
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF PENNYROYAL HEALTH CARE SERVICES, INC. 2017 273618164 2018-05-21 PENNYROYAL HEALTH CARE SERVICES, INC. 31
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2016-01-01
Business code 621111
Sponsor’s telephone number 2706326741
Plan sponsor’s address 310 HAWTHORNE ST., PRINCETON, KY, 424451522

Signature of
Role Plan administrator
Date 2018-05-21
Name of individual signing LINDA SMITH
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2018-05-21
Name of individual signing LINDA SMITH
Valid signature Filed with authorized/valid electronic signature

Secretary

Name Role
Rhonda Oldham Secretary

Treasurer

Name Role
Rhonda Oldham Treasurer

Vice President

Name Role
Chris Baird Vice President

Director

Name Role
Pat Godwin Director
Ramonda Quick Director
Jill Giordano Director
Amy Birdsong Director
DAVID PTASZEK Director
GALE CHERRY Director
PATSY OLIVER Director
Amy Berry Director
Millie Arnaez Director
Bobby Acree Director

President

Name Role
Jennifer East President

Registered Agent

Name Role
KECIA FULCHER Registered Agent

Incorporator

Name Role
DAVID PTASZEK Incorporator

Former Company Names

Name Action
PENNYROYAL HEALTH CARE SERVICES, INC. Old Name
PENNYROYAL HEALTHCARE SERVICES, INC. Old Name

Assumed Names

Name Status Expiration Date
COMMUNITY MEDICAL CLINIC, OAK GROVE Active 2028-10-05
PENNYROYAL HEALTH CARE SERVICES Inactive 2022-06-25
COMMUNITY MEDICAL CLINIC, PRINCETON Inactive 2021-03-02
COMMUNITY MEDICAL CLINIC, HOPKINSVILLE Inactive 2021-03-02
COMMUNITY MEDICAL CLINIC, PAK GROVE Inactive 2021-03-02

Filings

Name File Date
Annual Report 2024-08-12
Annual Report 2024-05-22
Certificate of Assumed Name 2023-10-05
Certificate of Assumed Name 2023-10-05
Certificate of Assumed Name 2023-10-05
Certificate of Assumed Name 2023-10-05
Annual Report 2023-10-03
Annual Report 2023-05-30
Amendment 2023-04-05
Registered Agent name/address change 2022-03-11

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
27-3618164 Corporation Unconditional Exemption 402 N JEFFERSON ST, PRINCETON, KY, 42445-1553 2011-02
In Care of Name % PENNYROYAL HEALTHCARE SERVICES
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Independent - This code is used if the organization is an independent organization or an independent auxiliary (i.e., not affiliated with a National, Regional, or Geographic grouping of organizations).
Classification Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Deductibility Contributions are deductible.
Foundation Hospital or medical research organization 170(b)(1)(A)(iii)
Tax Period 2023-09
Asset 5,000,000 to 9,999,999
Income 5,000,000 to 9,999,999
Filing Requirement 990 (all other) or 990EZ return
PF Filing Requirement No 990-PF return
Accounting Period Sep
Asset Amount 5416120
Income Amount 6248554
Form 990 Revenue Amount 6248554
National Taxonomy of Exempt Entities Health Care: Ambulatory Health Center, Community Clinic
Sort Name -

Publication 78 Data
Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Determination Letter
Final Letter(s) FinalLetter_27-3618164_PENNYROYALHEALTHCARESERVICESINC_07182011_01.tif

Form 990-N (e-Postcard)
Organization Name PENNYROYAL HEALTHCARE SERVICES INC
EIN 27-3618164
Tax Year 2013
Beginning of tax period 2013-07-01
End of tax period 2014-06-30
Gross receipts not greater than $50000 Yes
Organization has terminated No
Mailing Address 3999 Ft Campbell BLVD, Hopkinsville, KY, 42240, US
Principal Officer's Name David M Ptaszek
Principal Officer's Address 3999 Ft Campbell BLVD, Hopkinsville, KY, 42240, US
Website URL www.pennyroyalcenter.org
Organization Name PENNYROYAL HEALTHCARE SERVICES INC
EIN 27-3618164
Tax Year 2012
Beginning of tax period 2012-07-01
End of tax period 2013-06-30
Gross receipts not greater than $50000 Yes
Organization has terminated No
Mailing Address 3999 Ft Campbell BLVD, Hopkinsville, KY, 42240, US
Principal Officer's Name David M Ptaszek
Principal Officer's Address 3999 Ft Campbell BLVD, Hopkinsville, KY, 42240, US
Website URL www.pennyroyalcenter.org

Copies of Returns (990, 990-EZ, 990-PF, 990-T)
Organization Name PENNYROYAL HEALTH CARE SERVICES
EIN 27-3618164
Tax Period 202109
Filing Type E
Return Type 990
File View File
Organization Name PENNYROYAL HEALTH CARE SERVICES
EIN 27-3618164
Tax Period 202009
Filing Type E
Return Type 990
File View File
Organization Name PENNYROYAL HEALTH CARE SERVICES
EIN 27-3618164
Tax Period 201909
Filing Type E
Return Type 990
File View File
Organization Name PENNYROYAL HEALTH CARE SERVICES
EIN 27-3618164
Tax Period 201809
Filing Type E
Return Type 990
File View File
Organization Name PENNYROYAL HEALTH CARE SERVICES
EIN 27-3618164
Tax Period 201709
Filing Type E
Return Type 990
File View File
Organization Name PENNYROYAL HEALTH CARE SERVICES
EIN 27-3618164
Tax Period 201609
Filing Type E
Return Type 990
File View File
Organization Name PENNYROYAL HEALTH CARE SERVICES
EIN 27-3618164
Tax Period 201609
Filing Type P
Return Type 990
File View File
Organization Name PENNYROYAL HEALTH CARE SERVICES
EIN 27-3618164
Tax Period 201509
Filing Type E
Return Type 990
File View File
Organization Name PENNYROYAL HEALTH CARE SERVICES
EIN 27-3618164
Tax Period 201509
Filing Type P
Return Type 990
File View File
Organization Name PENNYROYAL HEALTH CARE SERVICES
EIN 27-3618164
Tax Period 201409
Filing Type E
Return Type 990
File View File
Organization Name PENNYROYAL HEALTH CARE SERVICES
EIN 27-3618164
Tax Period 201409
Filing Type P
Return Type 990
File View File

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
1644007103 2020-04-10 0457 PPP 310 HAWTHORNE ST, PRINCETON, KY, 42445-1622
Loan Status Date 2021-01-14
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 391912
Loan Approval Amount (current) 391912
Undisbursed Amount 0
Franchise Name -
Lender Location ID 120955
Servicing Lender Name Planters Bank, Inc.
Servicing Lender Address 1312 S Main St, HOPKINSVILLE, KY, 42240-2016
Rural or Urban Indicator R
Hubzone Y
LMI N
Business Age Description Existing or more than 2 years old
Project Address PRINCETON, CALDWELL, KY, 42445-1622
Project Congressional District KY-01
Number of Employees 45
NAICS code 621610
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 120955
Originating Lender Name Planters Bank, Inc.
Originating Lender Address HOPKINSVILLE, KY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 394579.18
Forgiveness Paid Date 2020-12-17
8694578302 2021-01-29 0457 PPS 310 Hawthorne St, Princeton, KY, 42445-1622
Loan Status Date 2021-10-15
Loan Status Paid in Full
Loan Maturity in Months 60
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 391913
Loan Approval Amount (current) 391913
Undisbursed Amount 0
Franchise Name -
Lender Location ID 120955
Servicing Lender Name Planters Bank, Inc.
Servicing Lender Address 1312 S Main St, HOPKINSVILLE, KY, 42240-2016
Rural or Urban Indicator R
Hubzone Y
LMI N
Business Age Description Existing or more than 2 years old
Project Address Princeton, CALDWELL, KY, 42445-1622
Project Congressional District KY-01
Number of Employees 53
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Non-Profit Organization
Originating Lender ID 120955
Originating Lender Name Planters Bank, Inc.
Originating Lender Address HOPKINSVILLE, KY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 394503.98
Forgiveness Paid Date 2021-09-28

Government Spending

Branch Date of Service Fiscal Year Cabinet Department Classification Item Name Amount
Executive 2025-02-24 2025 Health & Family Services Cabinet Department For Public Health Pro Contract (Inc Per Serv) Other Professional Services-1099 Rept 19555.47
Executive 2025-02-21 2025 Health & Family Services Cabinet Department For Public Health Pro Contract (Inc Per Serv) Other Professional Services-1099 Rept 40359.63
Executive 2025-01-10 2025 Health & Family Services Cabinet Department For Public Health Pro Contract (Inc Per Serv) Other Professional Services-1099 Rept 25946.66
Executive 2024-12-05 2025 Health & Family Services Cabinet Department For Public Health Pro Contract (Inc Per Serv) Other Professional Services-1099 Rept 12530.99
Executive 2024-10-30 2025 Health & Family Services Cabinet Department For Public Health Pro Contract (Inc Per Serv) Other Professional Services-1099 Rept 16183.3
Executive 2024-07-15 2025 Health & Family Services Cabinet Department For Public Health Pro Contract (Inc Per Serv) Other Professional Services-1099 Rept 8189.24
Executive 2023-09-22 2024 Health & Family Services Cabinet Department For Public Health Pro Contract (Inc Per Serv) Other Professional Services-1099 Rept 7882.63
Executive 2023-08-11 2024 Health & Family Services Cabinet Department For Public Health Pro Contract (Inc Per Serv) Other Professional Services-1099 Rept 8011.08
Executive 2023-07-19 2024 Health & Family Services Cabinet Department For Public Health Pro Contract (Inc Per Serv) Other Professional Services-1099 Rept 12661.06

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Sources: Kentucky Secretary of State

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