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EMPACT MIDWEST, LLC

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Company Details

Name: EMPACT MIDWEST, LLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 16 Jun 2020 (5 years ago)
Organization Date: 16 Jun 2020 (5 years ago)
Last Annual Report: 14 Nov 2024 (7 months ago)
Managed By: Members
Organization Number: 1100494
Industry: Health Services
Number of Employees: Small (0-19)
ZIP code: 40222
City: Louisville, Bancroft, Bellemeade, Crossgate, Glenvie...
Primary County: Jefferson County
Principal Office: 1052 RIVA RIDGE DRIVE, DANVILLE, KY 40222
Place of Formation: KENTUCKY

Member

Name Role
Eric Guerrant Member

Registered Agent

Name Role
S & H LEXINGTON, LLC Registered Agent

Organizer

Name Role
ALISON M ZEITLIN Organizer

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:
XG15K9WZJJL8
UEI Expiration Date:
2025-10-28

Business Information

Activation Date:
2024-10-29
Initial Registration Date:
2023-12-28

National Provider Identifier

NPI Number:
1841801784
Certification Date:
2022-07-14

Authorized Person:

Name:
DR. ERIC GUERRANT
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
363A00000X - Physician Assistant
Is Primary:
No
Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
363LA2100X - Acute Care Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
363LF0000X - Family Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
207P00000X - Emergency Medicine Physician
Is Primary:
Yes

Contacts:

Form 5500 Series

Employer Identification Number (EIN):
851454774
Plan Year:
2021
Number Of Participants:
17
Sponsors Telephone Number:
Plan Year:
2020
Number Of Participants:
17
Sponsors Telephone Number:

Filings

Name File Date
Reinstatement Certificate of Existence 2024-11-14
Reinstatement 2024-11-14
Reinstatement Approval Letter Revenue 2024-11-14
Administrative Dissolution 2022-10-04
Annual Report 2021-06-29

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Sources: Kentucky Secretary of State