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ST. ELIZABETH PHYSICIANS MAYSVILLE DIAGNOSTIC CENTER, LLC

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Company Details

Name: ST. ELIZABETH PHYSICIANS MAYSVILLE DIAGNOSTIC CENTER, LLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Good
Profit or Non-Profit: Profit
File Date: 05 Jun 2012 (13 years ago)
Organization Date: 05 Jun 2012 (13 years ago)
Last Annual Report: 20 Jun 2017 (8 years ago)
Managed By: Managers
Organization Number: 0830621
ZIP code: 41056
City: Maysville, Sardis
Primary County: Mason County
Principal Office: 910 KENTON STATION DRIVE, SUITE E, MAYSVILLE, KY 41056
Place of Formation: KENTUCKY

Manager

Name Role
LeRoy Gallenstein Manager
Audrey Spencer Manager
Jacob Bast Manager
Bruce Henley Manager

Organizer

Name Role
KATIE N. KOCH Organizer

Registered Agent

Name Role
ROBERT M. HOOFER Registered Agent

National Provider Identifier

NPI Number:
1659633774

Authorized Person:

Name:
DR. GLENN LOOMIS
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
261QR0200X - Radiology Clinic/Center
Is Primary:
No
Selected Taxonomy:
293D00000X - Physiological Laboratory
Is Primary:
No
Selected Taxonomy:
261Q00000X - Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
8593445552
Fax:
6067590075

Assumed Names

Name Status Expiration Date
SEP MDC Inactive 2022-06-26
MAYSVILLE DIAGNOSTIC CENTER Inactive 2017-09-20

Filings

Name File Date
Certificate of Withdrawal of Assumed Name 2017-09-15
Dissolution 2017-09-15
Annual Report 2017-06-20
Name Renewal 2017-02-08
Annual Report 2016-06-21

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Sources: Kentucky Secretary of State