|
FLAT BRANCH FARMS MEDOVA LIFESTYLE HEALTH PLAN
|
2021
|
611312965
|
2024-07-12
|
FLAT BRANCH FARMS
|
0
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2020-10-01
|
| Business code |
111100
|
| Sponsor’s telephone number |
2707365999
|
| Plan sponsor’s
address |
936 J I WEST RD, ISLAND, KY, 423509784
|
Plan administrator’s name and address
| Administrator’s EIN |
200200514 |
| Plan administrator’s name |
RECEIVERSHIP MANAGEMENT INC |
| Plan administrator’s
address |
510 HOSPITAL DR STE 490, MADISON, TN, 371155049 |
| Administrator’s telephone number |
6153700051 |
Signature of
| Role |
Plan administrator |
| Date |
2024-07-12 |
| Name of individual signing |
ROBERT MOORE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
|
FLAT BRANCH FARMS MEDOVA LIFESTYLE HEALTH PLAN
|
2020
|
611312965
|
2022-06-14
|
FLAT BRANCH FARMS
|
20
|
|
| File |
View Page
|
| Three-digit plan number (PN) |
501
|
| Effective date of plan |
2020-10-01
|
| Business code |
111100
|
| Sponsor’s telephone number |
2707365999
|
| Plan sponsor’s
address |
936 J I WEST RD, ISLAND, KY, 423509784
|
Plan administrator’s name and address
| Administrator’s EIN |
200200514 |
| Plan administrator’s name |
RECEIVERSHIP MANAGEMENT INC |
| Plan administrator’s
address |
510 HOSPITAL DR STE 490, MADISON, TN, 371155049 |
| Administrator’s telephone number |
6153700051 |
Signature of
| Role |
Plan administrator |
| Date |
2022-06-14 |
| Name of individual signing |
ROBERT MOORE |
| Valid signature |
Filed with authorized/valid electronic signature |
|
|
