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EAST BERNSTADT MEDICAL CLINIC, PLLC

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Company Details

Name: EAST BERNSTADT MEDICAL CLINIC, PLLC
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
Profit or Non-Profit: Profit
File Date: 08 Oct 2024 (9 months ago)
Organization Date: 01 Jan 2025 (7 months ago)
Managed By: Members
Organization Number: 1400404
ZIP code: 40447
City: Mc Kee, Clover Bottom, Eberle, Foxtown, Hisle, K...
Primary County: Jackson County
Principal Office: 25 Hwy 290, McKee , KY 40447
Place of Formation: KENTUCKY

Registered Agent

Name Role
David J Hays Registered Agent

Organizer

Name Role
David J Hays Organizer

National Provider Identifier

NPI Number:
1336109644
Certification Date:
2025-05-12

Authorized Person:

Name:
CARLA JEAN JOHNSON
Role:
BILLING/CREDENTIALING CLERK
Phone:

Taxonomy:

Selected Taxonomy:
207Q00000X - Family Medicine Physician
Is Primary:
No
Selected Taxonomy:
207R00000X - Internal Medicine Physician
Is Primary:
No
Selected Taxonomy:
208000000X - Pediatrics Physician
Is Primary:
No
Selected Taxonomy:
363AM0700X - Medical Physician Assistant
Is Primary:
No
Selected Taxonomy:
363L00000X - Nurse Practitioner
Is Primary:
No
Selected Taxonomy:
261QR1300X - Rural Health Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
6068436222
Fax:
6063643920

Former Company Names

Name Action
MCKEE MEDICAL CLINIC, PLLC PLLC Old Name

Filings

Name File Date
Amendment 2025-04-15
Articles of Organization 2024-10-08

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Sources: Kentucky Secretary of State