Menu
Search icon

KENTUCKY HEALTH COOPERATIVE, INC.

Company Details

Name: KENTUCKY HEALTH COOPERATIVE, INC.
Jurisdiction: Kentucky
Profit or Non-Profit: Non-profit
Legal type: Kentucky Corporation
Status: Inactive
Standing: Bad
File Date: 10 Nov 2011 (13 years ago)
Organization Date: 10 Nov 2011 (13 years ago)
Last Annual Report: 16 Jun 2023 (2 years ago)
Organization Number: 0805319
Principal Office: 20 10TH STREET, SUITE 803, ATLANTA, GA 30309-3867
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KENTUCKY HEALTH COOPERATIVE, INC 401(K) PLAN 2017 453763404 2018-08-30 KENTUCKY HEALTH COOPERATIVE, INC 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-04-01
Business code 524140
Sponsor’s telephone number 5023166668
Plan sponsor’s address 9700 ORMSBY STATION ROAD, LOUISVILLE, KY, 40223

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2018-08-30
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
KENTUCKY HEALTH COOPERATIVE, INC 401(K) PLAN 2016 453763404 2017-09-06 KENTUCKY HEALTH COOPERATIVE, INC 68
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-04-01
Business code 524140
Sponsor’s telephone number 5023166668
Plan sponsor’s address 9700 ORMSBY STATION ROAD, LOUISVILLE, KY, 40223

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2017-09-06
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
KENTUCKY HEALTH COOPERATIVE, INC 401(K) PLAN 2015 453763404 2017-09-06 KENTUCKY HEALTH COOPERATIVE, INC 65
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-04-01
Business code 524140
Sponsor’s telephone number 5023166668
Plan sponsor’s address 9700 ORMSBY STATION ROAD, LOUISVILLE, KY, 40223

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2017-09-06
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
KENTUCKY HEALTH COOPERATIVE, INC 401(K) PLAN 2015 453763404 2016-07-21 KENTUCKY HEALTH COOPERATIVE, INC 65
Three-digit plan number (PN) 001
Effective date of plan 2013-04-01
Business code 524140
Sponsor’s telephone number 5023166668
Plan sponsor’s address 9700 ORMSBY STATION ROAD, LOUISVILLE, KY, 40223

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2016-07-21
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
KENTUCKY HEALTH COOPERATIVE, INC 401(K) PLAN 2014 453763404 2015-07-01 KENTUCKY HEALTH COOPERATIVE, INC 37
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-04-01
Business code 524140
Sponsor’s telephone number 5023166668
Plan sponsor’s address 9700 ORMSBY STATION ROAD, LOUISVILLE, KY, 40223

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2015-07-01
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature
KENTUCKY HEALTH COOPERATIVE, INC 401(K) PLAN 2013 453763404 2014-07-22 KENTUCKY HEALTH COOPERATIVE, INC 0
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2013-04-01
Business code 524140
Sponsor’s telephone number 5023166668
Plan sponsor’s address 9700 ORMSBY STATION ROAD, LOUISVILLE, KY, 40223

Plan administrator’s name and address
Administrator’s EIN 621874769
Plan administrator’s name TAG RESOURCES, LLC
Plan administrator’s address 6322 DEANE HILL DRIVE, SUITE 201, KNOXVILLE, TN, 37919
Administrator’s telephone number 8656701844

Signature of
Role Plan administrator
Date 2014-07-22
Name of individual signing PHIL TISUE
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
PAUL C. HARNICE Registered Agent

CEO

Name Role
Donald F Roof CEO

Director

Name Role
Donald F Roof Director
Susan P Clark Director
Fatameh Aadelvand Director
TERRY SHILLING Director
JAMES A. DIETZ Director
ROBIN J. FISK Director

Incorporator

Name Role
ALAN J. HARTMAN Incorporator

Assumed Names

Name Status Expiration Date
KENTUCKY HEALTH COOPERATIVE Inactive 2019-03-11

Filings

Name File Date
Administrative Dissolution 2024-10-12
Annual Report 2023-06-16
Unhonored Check Letter 2023-05-04
Annual Report 2022-03-28
Annual Report 2021-02-10
Principal Office Address Change 2021-02-10
Annual Report 2020-08-27
Reinstatement 2019-09-24
Reinstatement Approval Letter Revenue 2019-09-24
Reinstatement Certificate of Existence 2019-09-24

Related by officers

PAUL C. HARNICE

THE JOHN DOUGLAS HARNICE MEMORIAL SCHOLARSHIP FUND, INC. INVERNESS ROAD - AIRDRIE LANE NEIGHBORHOOD ASSOCIATION, INC. STOLL, KEENON & PARK, LLP RIVER BEND DEVELOPMENT COMPANY, INC. RJ INDUSTRIES, LLC JOHNSON, TRUE & GUARNIERI, LLP THE DERBY CORPORATION ESTILL ENTERPRISES, LLC FORKS OF ELKHORN FARMS, LLC RICHIE FARMER CHARITABLE FOUNDATION, INC.

JAMES A. DIETZ

ALL WOMAN, PLLC SUSAN J. CONRAD, LLC H & H LANDSCAPING AND LAWN CARE, LLC CONTINUECARE HOSPITAL AT BAPTIST HEALTH, LLC CORBIN LTACH VENTURE, LLC ST. ELIZABETH PROVIDER NETWORK, INC. THE AMARIS GROUP, INC. ATHLETES AGAIN SPORTS, INC. INTEGRITY INNOVATIONS NKY, LLC EASTERN KENTUCKY HEALTHCARE CONSORTIUM, INC.

ALAN J. HARTMAN

FORREST RIDGE LLC ISON CAULKING SERVICES, LLC ISON CAULKING & WATERPROOFING, LLC TRIANGLE METAL BUILDING SERVICES, INC. NORTHERN KENTUCKY SOCCER ACADEMY, INC. UPTECH VISION, LLC COMMUNITY PLUS LLC UPTECH, INC. HIGHLANDS HEART AND VASCULAR, LLC C & J HARTMAN FAMILY, LLC

Related by address

No related companies by address

Date of last update: 12 Jan 2025

Sources: Kentucky Secretary of State

Privacy policy Policy
About us About us
Contacts Contact us

© 2025 kyprofile.com, Part of Big Data Integrated