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ADVANCED FAMILY MEDICAL CLINIC LIBERTY, LLC

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Company Details

Name: ADVANCED FAMILY MEDICAL CLINIC LIBERTY, LLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 15 May 2017 (8 years ago)
Organization Date: 15 May 2017 (8 years ago)
Last Annual Report: 15 Feb 2025 (4 months ago)
Managed By: Members
Organization Number: 0985562
Industry: Social Services
Number of Employees: Small (0-19)
ZIP code: 40423
City: Danville
Primary County: Boyle County
Principal Office: PO BOX 2369, DANVILLE, KY 40423-2369
Place of Formation: KENTUCKY

Member

Name Role
Khursheed Siddiqui Member
Sheeba Siddiqui Member

Organizer

Name Role
KHURSHEED SIDDIQUI Organizer

Registered Agent

Name Role
KHURSHEED SIDDIQUI Registered Agent

Unique Entity ID

A UEI is a government-provided number, like a tax ID number, that’s used to identify businesses eligible for federal grants, awards and contracts.

Note: In April 2022, the federal government replaced its old identifier of choice, the Data Universal Numbering System (DUNS) number, with a government-issued UEI. Now all the federal government’s Integrated Award Environment systems use UEI numbers instead of DUNS numbers. So any entity doing business with the federal government must register for a UEI.

Unique Entity ID:
YNVGQL7DJUJ9
CAGE Code:
91YZ6
UEI Expiration Date:
2022-07-10

Business Information

Activation Date:
2021-06-15
Initial Registration Date:
2021-06-10

National Provider Identifier

NPI Number:
1023545241
Certification Date:
2023-04-20

Authorized Person:

Name:
DR. KHURSHEED AKRAM SIDDIQUI
Role:
MEDICAL DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
No
Selected Taxonomy:
261QR1300X - Rural Health Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
6063039170

Form 5500 Series

Employer Identification Number (EIN):
821533789
Plan Year:
2023
Number Of Participants:
28
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
23
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
30
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
21
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
16
Sponsors Telephone Number:

Filings

Name File Date
Registered Agent name/address change 2025-02-15
Annual Report 2025-02-15
Annual Report 2024-03-08
Annual Report 2023-03-17
Annual Report 2022-03-06

USAspending Awards / Financial Assistance

Date:
2021-07-21
Awarding Agency Name:
Department of Health and Human Services
Transaction Description:
RURAL HEALTH CLINIC VACCINE CONFIDENCE PROGRAM
Obligated Amount:
0.00
Face Value Of Loan:
0.00
Total Face Value Of Loan:
0.00
Date:
2020-06-23
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:
126500.00
Total Face Value Of Loan:
126500.00
Date:
2020-05-03
Awarding Agency Name:
Small Business Administration
Transaction Description:
TO AID SMALL BUSINESSES IN MAINTAINING WORK FORCE DURING COVID-19 PANDEMIC.
Obligated Amount:
0.00
Face Value Of Loan:
113300.00
Total Face Value Of Loan:
113300.00

Paycheck Protection Program

Date Approved:
2020-05-01
Loan Status:
Paid in Full
SBA Guaranty Percentage:
100
Initial Approval Amount:
113300
Current Approval Amount:
113300
Race:
Unanswered
Ethnicity:
Unknown/NotStated
Gender:
Male Owned
Veteran:
Non-Veteran
Forgiveness Amount:
114656.45

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Sources: Kentucky Secretary of State