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Platinum Anesthesia, LLC

Company Details

Name: Platinum Anesthesia, LLC
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Bad
Profit or Non-Profit: Profit
File Date: 26 Apr 2021 (4 years ago)
Organization Date: 26 Apr 2021 (4 years ago)
Last Annual Report: 11 Aug 2022 (3 years ago)
Managed By: Members
Organization Number: 1146971
ZIP code: 40241
City: Louisville, Barbourmeade, Broeck Pointe, Brownsboro ...
Primary County: Jefferson County
Principal Office: 4205 Springhurst Blvd Ste 101, Louisville, KY 40241
Place of Formation: KENTUCKY

Registered Agent

Name Role
Lisa K Hastetter Registered Agent

Member

Name Role
Lisa K Hastetter Member
Matt Elkins Member

Organizer

Name Role
Lisa K Hastetter Organizer
Lisa Hastetter Organizer
Matt R Elkins Organizer

National Provider Identifier

NPI Number:
1720660095
Certification Date:
2022-06-01

Authorized Person:

Name:
TIMOTHY BEACHAM
Role:
OWNER
Phone:

Taxonomy:

Selected Taxonomy:
207LC0200X - Critical Care Medicine (Anesthesiology) Physician
Is Primary:
No
Selected Taxonomy:
207LH0002X - Hospice and Palliative Medicine (Anesthesiology) Physician
Is Primary:
No
Selected Taxonomy:
207LP2900X - Pain Medicine (Anesthesiology) Physician
Is Primary:
No
Selected Taxonomy:
367500000X - Certified Registered Nurse Anesthetist
Is Primary:
No
Selected Taxonomy:
207L00000X - Anesthesiology Physician
Is Primary:
Yes

Contacts:

Filings

Name File Date
Administrative Dissolution 2023-10-04
Annual Report 2022-08-11

Sources: Kentucky Secretary of State