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TEMPLE TRIAGE, PLLC

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Company Details

Name: TEMPLE TRIAGE, PLLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 20 Jun 2019 (6 years ago)
Organization Date: 20 Jun 2019 (6 years ago)
Last Annual Report: 10 Sep 2021 (4 years ago)
Managed By: Managers
Organization Number: 1062547
ZIP code: 40211
City: Louisville
Primary County: Jefferson County
Principal Office: 2600 WEST BROADWAY, SUITE 208, Louisville, KY 40211
Place of Formation: KENTUCKY

Manager

Name Role
TaWanda Whidby Manager

Registered Agent

Name Role
TAWANDA WHIDBY Registered Agent

Organizer

Name Role
TAWANDA WHIDBY Organizer

National Provider Identifier

NPI Number:
1679192611
Certification Date:
2020-04-09

Authorized Person:

Name:
TAWANDA NACOLE WHIDBY
Role:
PROVIDER/OWNER
Phone:

Taxonomy:

Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
5026184891

Filings

Name File Date
Administrative Dissolution 2022-10-04
Annual Report 2021-09-10
Reinstatement Certificate of Existence 2020-12-22
Reinstatement 2020-12-22
Reinstatement Approval Letter Revenue 2020-12-22

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Sources: Kentucky Secretary of State