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Commonwealth Pain Specialists, PLLC

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Company Details

Name: Commonwealth Pain Specialists, PLLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 10 Aug 2011 (14 years ago)
Organization Date: 10 Aug 2011 (14 years ago)
Last Annual Report: 22 Jun 2022 (3 years ago)
Managed By: Managers
Organization Number: 0797827
ZIP code: 40601
City: Frankfort, Hatton
Primary County: Franklin County
Principal Office: 279 King's Daughters Drive, Suite 100, Frankfort, KY 40601
Place of Formation: KENTUCKY

Organizer

Name Role
William G. (Jerry) Fowler II, PLLC Organizer

Member

Name Role
Richard Lingreen Member

National Provider Identifier

NPI Number:
1700161981

Authorized Person:

Name:
TAMIA FISHER
Role:
CREDENTIALING SPECIALIST
Phone:

Taxonomy:

Selected Taxonomy:
332B00000X - Durable Medical Equipment & Medical Supplies
Is Primary:
No
Selected Taxonomy:
207LP2900X - Pain Medicine (Anesthesiology) Physician
Is Primary:
Yes

Contacts:

Fax:
8124766162
Fax:
5023522534

Licenses

Department License Number License Type / Line of Authority Status Issue Date Effective Date Inactive Date Expiry Date Address
Department of Professional Licensing 240943 Home Medical Equipment and Services Provider Incomplete Application - - - - 279 King's Daughters Dr. Ste. 100, Frankfort, KY 40601
Department of Professional Licensing 260735 Home Medical Equipment and Services Provider Expired 2019-10-21 - - 2022-09-30 279 Kings Daughters Dr. Ste. 100, Frankfort, KY 40601

Assumed Names

Name Status Expiration Date
VITALITY REGENERATIVE MEDICINE Inactive 2023-08-01
VITALITY LABORATORIES Inactive 2023-08-01
VITALITY PAIN CENTERS Inactive 2023-08-01
VITALITY WELLNESS CENTERS Inactive 2023-08-01

Filings

Name File Date
Agent Resignation 2023-01-20
Annual Report 2022-06-22
Annual Report 2021-06-01
Annual Report 2020-04-01
Annual Report 2019-04-24

USAspending Awards / Financial Assistance

Date:
2022-02-07
Awarding Agency Name:
Small Business Administration
Transaction Description:
AWARDTYPE: DIRECT LOANS ACTIVITIES TO BE PERFORMED: PROVIDE LOANS TO BUSINESSES IMPACTED BY THE COVID-19 PANDEMIC FOR UNINSURED OR OTHERWISE UNCOMPENSATED ECONOMIC INJURY. DELIVERABLES: LOANS EXPECTED OUTCOMES: EXPECTED OUTCOMES: ENABLE BUSINESSES TO FUND POST-DISASTER ORDINARY AND NECESSARY OPERATING EXPENSES UNTIL NORMAL OPERATIONS RESUME INTENDED BENEFICIARIES: SURVIVORS OF DISASTER SUBRECIPIENT ACTIVITIES: NA
Obligated Amount:
0.00
Face Value Of Loan:
121000.00
Total Face Value Of Loan:
121000.00
Date:
2020-06-11
Awarding Agency Name:
Small Business Administration
Transaction Description:
ECONOMIC INJURY DISASTER GRANT
Obligated Amount:
10000.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-04-20
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO PROVIDE LOANS TO RESTORE AS NEARLY AS POSSIBLE THE VICTIMS OF ECONOMIC INJURY TYPE DISASTERS TO PRE-DISASTER CONDITIONS
Obligated Amount:
0.00
Face Value Of Loan:
400300.00
Total Face Value Of Loan:
400300.00

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Sources: Kentucky Secretary of State