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  5. BLUEGRASS FAMILY ALLERGY, PLLC

BLUEGRASS FAMILY ALLERGY, PLLC

Company Details

Name: BLUEGRASS FAMILY ALLERGY, PLLC
Jurisdiction: Kentucky
Profit or Non-Profit: Profit
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Good
File Date: 12 Nov 2014 (10 years ago)
Organization Date: 12 Nov 2014 (10 years ago)
Last Annual Report: 17 Mar 2023 (2 years ago)
Managed By: Managers
Organization Number: 0902063
ZIP code: 42303
Primary County: Daviess
Principal Office: 2200 E PARRISH AVE BUILDING C, 2200 E PARRISH AVE STE 101C, OWENSBORO, OWENSBORO, KY 42303-1450
Place of Formation: KENTUCKY

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BLUEGRASS FAMILY ALLERGY, PLLC SAFE HARBOR 401(K)PLAN 2023 472328315 2024-03-14 BLUEGRASS FAMILY ALLERGY, PLLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-08-01
Business code 621111
Sponsor’s telephone number 2702282811
Plan sponsor’s address P.O. BOX 22230, BUILDING C, OWENSBORO, KY, 42304
BLUEGRASS FAMILY ALLERGY PLLC CBS BENEFIT PLAN 2022 472328315 2023-12-27 BLUEGRASS FAMILY ALLERGY PLLC 3
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2020-01-01
Business code 621491
Sponsor’s telephone number 2702282811
Plan sponsor’s address 2200 E. PARRISH AVE, BLDG C 101, OWENSBORO, KY, 42303

Plan administrator’s name and address
Administrator’s EIN 846429706
Plan administrator’s name SHAWNA BURTON
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of
Role Plan administrator
Date 2023-12-27
Name of individual signing SHAWNA BURTON
Valid signature Filed with authorized/valid electronic signature
BLUEGRASS FAMILY ALLERGY, PLLC SAFE HARBOR 401(K)PLAN 2022 472328315 2023-03-13 BLUEGRASS FAMILY ALLERGY, PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-08-01
Business code 621111
Sponsor’s telephone number 2702282811
Plan sponsor’s address 2200 EAST PARRISH AVENUE, BUILDING C, OWENSBORO, KY, 42303
BLUEGRASS FAMILY ALLERGY, PLLC SAFE HARBOR 401(K)PLAN 2021 472328315 2022-03-29 BLUEGRASS FAMILY ALLERGY, PLLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-08-01
Business code 621111
Sponsor’s telephone number 2702282811
Plan sponsor’s address 2200 EAST PARRISH AVENUE, BUILDING C, OWENSBORO, KY, 42303
BLUEGRASS FAMILY ALLERGY PLLC CBS BENEFIT PLAN 2021 472328315 2022-12-29 BLUEGRASS FAMILY ALLERGY PLLC 3
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2020-01-01
Business code 621491
Sponsor’s telephone number 2702282811
Plan sponsor’s address 2200 E. PARRISH AVE, BLDG C 101, OWENSBORO, KY, 42303

Plan administrator’s name and address
Administrator’s EIN 846429706
Plan administrator’s name SHAWNA BURTON
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of
Role Plan administrator
Date 2022-12-29
Name of individual signing SHAWNA BURTON
Valid signature Filed with authorized/valid electronic signature
BLUEGRASS FAMILY ALLERGY, PLLC SAFE HARBOR 401(K)PLAN 2020 472328315 2021-04-01 BLUEGRASS FAMILY ALLERGY, PLLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-08-01
Business code 621111
Sponsor’s telephone number 2702282811
Plan sponsor’s address 2200 EAST PARRISH AVENUE, BUILDING C, OWENSBORO, KY, 42303
BLUEGRASS FAMILY ALLERGY PLLC CBS BENEFIT PLAN 2020 472328315 2021-12-14 BLUEGRASS FAMILY ALLERGY PLLC 4
File View Page
Three-digit plan number (PN) 501
Effective date of plan 2020-01-01
Business code 621491
Sponsor’s telephone number 2702282811
Plan sponsor’s address 2200 E. PARRISH AVE, BLDG C 101, OWENSBORO, KY, 42303

Plan administrator’s name and address
Administrator’s EIN 846429706
Plan administrator’s name SHAWNA BURTON
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of
Role Plan administrator
Date 2021-12-14
Name of individual signing SHAWNA BURTON
Valid signature Filed with authorized/valid electronic signature
BLUEGRASS FAMILY ALLERGY PLLC CBS BENEFIT PLAN 2019 472328315 2020-12-23 BLUEGRASS FAMILY ALLERGY PLLC 4
Three-digit plan number (PN) 501
Effective date of plan 2020-01-01
Business code 621491
Sponsor’s telephone number 2702282811
Plan sponsor’s address 2200 E. PARRISH AVE BLDG C 101, OWENSBORO, KY, 42303

Plan administrator’s name and address
Administrator’s EIN 846429706
Plan administrator’s name KELLY WOLF
Plan administrator’s address 464 CHENAULT RD, FRANKFORT, KY, 40601
Administrator’s telephone number 5026954700

Signature of
Role Plan administrator
Date 2020-12-23
Name of individual signing KELLY WOLF
Valid signature Filed with authorized/valid electronic signature
BLUEGRASS FAMILY ALLERGY, PLLC SAFE HARBOR 401(K)PLAN 2019 472328315 2020-03-25 BLUEGRASS FAMILY ALLERGY, PLLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-08-01
Business code 621111
Sponsor’s telephone number 2702282811
Plan sponsor’s address 2200 EAST PARRISH AVENUE, BUILDING C, OWENSBORO, KY, 42303
BLUEGRASS FAMILY ALLERGY, PLLC SAFE HARBOR 401(K)PLAN 2018 472328315 2019-03-26 BLUEGRASS FAMILY ALLERGY, PLLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2015-08-01
Business code 621111
Sponsor’s telephone number 2702282811
Plan sponsor’s address 2200 EAST PARRISH AVENUE, BUILDING C, OWENSBORO, KY, 42303
File https://efast2-filings-public.s3.amazonaws.com/prd/2018/05/10/20180510113357P040060399377002.pdf
Three-digit plan number (PN) 001
Effective date of plan 2015-08-01
Business code 621111
Sponsor’s telephone number 2702282811
Plan sponsor’s address 2200 EAST PARRISH AVENUE, BUILDING A, OWENSBORO, KY, 42303
File https://efast2-filings-public.s3.amazonaws.com/prd/2017/04/12/20170412155320P030082554903002.pdf
Three-digit plan number (PN) 001
Effective date of plan 2015-08-01
Business code 621111
Sponsor’s telephone number 2702282811
Plan sponsor’s address 2200 EAST PARRISH AVENUE, BUILDING A, OWENSBORO, KY, 42303
File https://efast2-filings-public.s3.amazonaws.com/prd/2016/03/14/20160314122530P040001601233001.pdf
Three-digit plan number (PN) 001
Effective date of plan 2015-08-01
Business code 621111
Sponsor’s telephone number 2702282811
Plan sponsor’s address 2200 EAST PARRISH AVENUE, BUILDING A, OWENSBORO, KY, 42303

Registered Agent

Name Role
KELLY BRAUER, M.D. Registered Agent

Manager

Name Role
Kelly S Brauer Manager

Organizer

Name Role
KELLY BRAUER, M.D. Organizer

Filings

Name File Date
Dissolution 2023-12-28
Annual Report 2023-03-17
Annual Report 2022-03-10
Principal Office Address Change 2021-03-30
Annual Report 2021-03-30
Annual Report 2020-04-09
Annual Report 2019-05-15
Annual Report 2018-06-01
Annual Report 2017-03-09
Annual Report 2016-03-10

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Related by address

No related companies by address

Date of last update: 16 Nov 2024

Sources: Kentucky Secretary of State

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