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  5. EAST KENTUCKY HEALTHCARE, LLC

EAST KENTUCKY HEALTHCARE, LLC

Company Details

Name: EAST KENTUCKY HEALTHCARE, LLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 15 Feb 2012 (13 years ago)
Organization Date: 15 Feb 2012 (13 years ago)
Managed By: Managers
Organization Number: 0821735
ZIP code: 41653
City: Prestonsburg, Emma, Endicott, Hippo
Primary County: Floyd County
Principal Office: 75 THEATRE COURT, PRESTONSBURG, KY 41653
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
EAST KENTUCKY HEALTHCARE CASH BALANCE PENSION PLAN 2023 611396205 2024-10-11 EAST KENTUCKY HEALTHCARE 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 6062371000
Plan sponsor’s address 306 HOSPITAL DRIVE, SUITE #101, SOUTH WILLIAMSON, KY, 41503

Signature of
Role Plan administrator
Date 2024-10-11
Name of individual signing MANSOOR MAHMOOD, M.D.
Valid signature Filed with authorized/valid electronic signature
EAST KENTUCKY HEALTHCARE PROFIT SHARING PLAN 2023 611396205 2024-10-03 EAST KENTUCKY HEALTHCARE 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6064563477
Plan sponsor’s address 48 PHILLIPS BRANCH ROAD, PHELPS, KY, 41553

Signature of
Role Plan administrator
Date 2024-10-03
Name of individual signing MANSOOR MAHMOOD MD
Valid signature Filed with authorized/valid electronic signature
EAST KENTUCKY HEALTHCARE CASH BALANCE PENSION PLAN 2023 611396205 2024-11-21 EAST KENTUCKY HEALTHCARE 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 6064563477
Plan sponsor’s address 48 PHILLIPS BRANCH ROAD, PHELPS, KY, 41553

Signature of
Role Plan administrator
Date 2024-11-21
Name of individual signing MANSOOR MAHMOOD, M.D.
Valid signature Filed with authorized/valid electronic signature
EAST KENTUCKY HEALTHCARE CASH BALANCE PENSION PLAN 2022 611396205 2023-10-11 EAST KENTUCKY HEALTHCARE 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 6062371000
Plan sponsor’s address 306 HOSPITAL DRIVE, SUITE #101, SOUTH WILLIAMSON, KY, 41503

Signature of
Role Plan administrator
Date 2023-10-11
Name of individual signing MANSOOR MAHMOOD, M.D.
Valid signature Filed with authorized/valid electronic signature
EAST KENTUCKY HEALTHCARE PROFIT SHARING PLAN 2022 611396205 2023-10-05 EAST KENTUCKY HEALTHCARE 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6064563477
Plan sponsor’s address 48 PHILLIPS BRANCH ROAD, PHELPS, KY, 41553

Signature of
Role Plan administrator
Date 2023-10-06
Name of individual signing MANSOOR MAHMOOD MD
Valid signature Filed with authorized/valid electronic signature
EAST KENTUCKY HEALTHCARE PROFIT SHARING PLAN 2021 611396205 2022-08-12 EAST KENTUCKY HEALTHCARE 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6064563477
Plan sponsor’s address 48 PHILLIPS BRANCH ROAD, PHELPS, KY, 41553

Signature of
Role Plan administrator
Date 2022-08-12
Name of individual signing MANSOOR MAHMOOD MD
Valid signature Filed with authorized/valid electronic signature
EAST KENTUCKY HEALTHCARE CASH BALANCE PENSION PLAN 2021 611396205 2022-09-30 EAST KENTUCKY HEALTHCARE 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 6062371000
Plan sponsor’s address 306 HOSPITAL DRIVE, SUITE #101, SOUTH WILLIAMSON, KY, 41503

Signature of
Role Plan administrator
Date 2022-09-30
Name of individual signing MANSOOR MAHMOOD, M.D.
Valid signature Filed with authorized/valid electronic signature
EAST KENTUCKY HEALTHCARE PROFIT SHARING PLAN 2020 611396205 2021-09-24 EAST KENTUCKY HEALTHCARE 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6064563477
Plan sponsor’s address 48 PHILLIPS BRANCH ROAD, PHELPS, KY, 41553

Signature of
Role Plan administrator
Date 2021-09-24
Name of individual signing MANSOOR MAHMOOD MD
Valid signature Filed with authorized/valid electronic signature
EAST KENTUCKY HEALTHCARE CASH BALANCE PENSION PLAN 2020 611396205 2021-10-12 EAST KENTUCKY HEALTHCARE 5
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 6062371000
Plan sponsor’s address 306 HOSPITAL DRIVE, SUITE #101, SOUTH WILLIAMSON, KY, 41503

Signature of
Role Plan administrator
Date 2021-10-12
Name of individual signing MANSOOR MAHMOOD, M.D.
Valid signature Filed with authorized/valid electronic signature
EAST KENTUCKY HEALTHCARE PROFIT SHARING PLAN 2019 611396205 2020-09-04 EAST KENTUCKY HEALTHCARE 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6064563477
Plan sponsor’s address 48 PHILLIPS BRANCH ROAD, PHELPS, KY, 41553

Signature of
Role Plan administrator
Date 2020-09-04
Name of individual signing MANSOOR MAHMOOD MD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2020/10/14/20201014091118NAL0005807217001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 6062371000
Plan sponsor’s address 306 HOSPITAL DRIVE, SUITE #101, SOUTH WILLIAMSON, KY, 41503

Signature of
Role Plan administrator
Date 2020-10-14
Name of individual signing MANSOOR MAHMOOD, M.D.
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2019/10/14/20191014104017P030052975805001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 6062371000
Plan sponsor’s address 306 HOSPITAL DRIVE, SUITE #101, SOUTH WILLIAMSON, KY, 41503

Signature of
Role Plan administrator
Date 2019-10-14
Name of individual signing MANSOOR MAHMOOD, M.D.
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2019/09/09/20190909132429P040004314673001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6064563477
Plan sponsor’s address 48 PHILLIPS BRANCH ROAD, PHELPS, KY, 41553

Signature of
Role Plan administrator
Date 2019-09-09
Name of individual signing MANSOOR MAHMOOD MD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2018/10/11/20181011133542P040247850631001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 6062371000
Plan sponsor’s address 306 HOSPITAL DRIVE, SUITE #101, SOUTH WILLIAMSON, KY, 41503

Signature of
Role Plan administrator
Date 2018-10-11
Name of individual signing MANSOOR MAHMOOD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2018/09/21/20180921141606P030143154221001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6064563477
Plan sponsor’s address 48 PHILLIPS BRANCH ROAD, PHELPS, KY, 41553

Signature of
Role Plan administrator
Date 2018-09-21
Name of individual signing MANSOOR MAHMOOD MD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/10/12/20171012101748P030169367181001.pdf
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 6062371000
Plan sponsor’s address 306 HOSPITAL DRIVE, SUITE #101, SOUTH WILLIAMSON, KY, 41503

Signature of
Role Plan administrator
Date 2017-10-12
Name of individual signing MANSOOR MAHMOOD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/10/05/20171005131835P030176497959001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6064563477
Plan sponsor’s address 48 PHILLIPS BRANCH ROAD, PHELPS, KY, 41553

Signature of
Role Plan administrator
Date 2017-10-05
Name of individual signing MANSOOR MAHMOOD MD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/17/20161017104829P040030798199002.pdf
Three-digit plan number (PN) 002
Effective date of plan 2015-01-01
Business code 621111
Sponsor’s telephone number 6062371000
Plan sponsor’s address 306 HOSPITAL DRIVE, SUITE #101, SOUTH WILLIAMSON, KY, 41503

Signature of
Role Plan administrator
Date 2016-10-17
Name of individual signing MANSOOR MAHMOOD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/10/14/20161014110049P040000874969001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6064563477
Plan sponsor’s address 48 PHILLIPS BRANCH ROAD, PHELPS, KY, 41553

Signature of
Role Plan administrator
Date 2016-10-14
Name of individual signing MANSOOR MAHMOOD MD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2015/10/13/20151013135530P040041567447001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6064563477
Plan sponsor’s address 48 PHILLIPS BRANCH ROAD, PHELPS, KY, 41553

Signature of
Role Plan administrator
Date 2015-10-13
Name of individual signing MANSOOR MAHMOOD MD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2014/09/10/20140910092831P040039907903001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6064563477
Plan sponsor’s address 48 PHILLIPS BRANCH ROAD, PHELPS, KY, 41553

Signature of
Role Plan administrator
Date 2014-09-10
Name of individual signing MANSOOR MAHMOOD MD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2013/10/15/20131015151204P040002102882001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6064563477
Plan sponsor’s address 48 PHILLIPS BRANCH ROAD, PHELPS, KY, 41553

Signature of
Role Plan administrator
Date 2013-10-15
Name of individual signing MANSOOR MAHMOOD MD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2012/10/12/20121012203818P040000930375001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6064563477
Plan sponsor’s address 48 PHILLIPS BRANCH ROAD, PHELPS, KY, 41553

Plan administrator’s name and address
Administrator’s EIN 611396205
Plan administrator’s name EAST KENTUCKY HEALTHCARE
Plan administrator’s address 48 PHILLIPS BRANCH ROAD, PHELPS, KY, 41553
Administrator’s telephone number 6064563477

Signature of
Role Plan administrator
Date 2012-10-12
Name of individual signing MANSOOR MAHMOOD MD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2011/10/10/20111010152758P040149633425001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6064563477
Plan sponsor’s address 48 PHILLIPS BRANCH ROAD, PHELPS, KY, 41553

Plan administrator’s name and address
Administrator’s EIN 611396205
Plan administrator’s name EAST KENTUCKY HEALTHCARE
Plan administrator’s address 48 PHILLIPS BRANCH ROAD, PHELPS, KY, 41553
Administrator’s telephone number 6064563477

Signature of
Role Plan administrator
Date 2011-10-10
Name of individual signing MANSOOR MAHMOOD MD
Valid signature Filed with authorized/valid electronic signature
File https://efast2-filings-public.s3.amazonaws.com/prd/2010/10/12/20101012101833P030022414129002.pdf
Three-digit plan number (PN) 001
Effective date of plan 2004-01-01
Business code 621111
Sponsor’s telephone number 6064563477
Plan sponsor’s address 48 PHILLIPS BRANCH ROAD, PHELPS, KY, 41553

Plan administrator’s name and address
Administrator’s EIN 611396205
Plan administrator’s name EAST KENTUCKY HEALTHCARE
Plan administrator’s address 48 PHILLIPS BRANCH ROAD, PHELPS, KY, 41553
Administrator’s telephone number 6064563477

Signature of
Role Plan administrator
Date 2010-10-12
Name of individual signing MANSOOR MAHMOOD MD
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
CAMILLE HELSEL Registered Agent

Organizer

Name Role
STEVE WILLIAMS Organizer

Filings

Name File Date
Administrative Dissolution 2013-09-28
Principal Office Address Change 2012-06-07
Registered Agent name/address change 2012-06-07
Articles of Organization (LLC) 2012-02-15

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
3420167301 2020-04-29 0457 PPP PO BOX 164, FOREST HILLS, KY, 41527
Loan Status Date 2021-07-20
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 45700
Loan Approval Amount (current) 45700
Undisbursed Amount 0
Franchise Name -
Lender Location ID 27783
Servicing Lender Name Community Trust Bank, Inc.
Servicing Lender Address 346 N Mayo Trl, PIKEVILLE, KY, 41501-1847
Rural or Urban Indicator R
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address FOREST HILLS, PIKE, KY, 41527-0001
Project Congressional District KY-05
Number of Employees 4
NAICS code 621111
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Sole Proprietorship
Originating Lender ID 27783
Originating Lender Name Community Trust Bank, Inc.
Originating Lender Address PIKEVILLE, KY
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 46215.85
Forgiveness Paid Date 2021-06-24

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Sources: Kentucky Secretary of State

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