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LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES, PLLC

Company Details

Name: LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES, PLLC
Jurisdiction: Kentucky
Profit or Non-Profit: Profit
Legal type: Kentucky Limited Liability Company
Status: Inactive
Standing: Bad
File Date: 22 May 2003 (21 years ago)
Organization Date: 22 May 2003 (21 years ago)
Organization Number: 0560614
Primary County: Pulaski
Place of Formation: KENTUCKY
Last Annual Report: 19 Jul 2013 (11 years ago)
Managed By: Managers
Principal Office: 349 BOGLE STREET, SOMERSET, KY 42503
Principal Office ZIP code: 42503

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES DEFINED BENEFIT PLAN & TRUST 2013 141879871 2014-10-15 LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6064519448
Plan sponsor’s address 349 BOGLE STREET, SOMERSET, KY, 42501
LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES DEFINED BENEFIT PLAN & TRUST 2013 141879871 2014-10-15 LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6064519448
Plan sponsor’s address 349 BOGLE STREET, SOMERSET, KY, 42501
LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES DEFINED BENEFIT PLAN & TRUST 2012 141879871 2013-10-11 LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6064519448
Plan sponsor’s address 349 BOGLE STREET, SOMERSET, KY, 42501

Signature of
Role Plan administrator
Date 2013-10-11
Name of individual signing DR. ROBERT CAMERON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-11
Name of individual signing DR. ROBERT CAMERON
Valid signature Filed with authorized/valid electronic signature
LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES DEFINED BENEFIT PLAN & TRUST 2011 141879871 2012-06-18 LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6064519448
Plan sponsor’s address 349 BOGLE STREET, SOMERSET, KY, 42501

Plan administrator’s name and address
Administrator’s EIN 141879871
Plan administrator’s name LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES
Plan administrator’s address 349 BOGLE STREET, SOMERSET, KY, 42501
Administrator’s telephone number 6064519448

Signature of
Role Plan administrator
Date 2012-06-18
Name of individual signing THERESA STILLEY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-06-18
Name of individual signing THERESA STILLEY
Valid signature Filed with authorized/valid electronic signature
LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES DEFINED BENEFIT PLAN & TRUST 2010 141879871 2011-10-14 LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES 17
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6064519448
Plan sponsor’s address 349 BOGLE STREET, SOMERSET, KY, 42501

Plan administrator’s name and address
Administrator’s EIN 141879871
Plan administrator’s name LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES
Plan administrator’s address 349 BOGLE STREET, SOMERSET, KY, 42501
Administrator’s telephone number 6064519448

Signature of
Role Plan administrator
Date 2011-10-14
Name of individual signing DR. ROBERT CAMERON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-10-14
Name of individual signing DR. ROBERT CAMERON
Valid signature Filed with authorized/valid electronic signature
LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES 401K PLAN 2009 141879871 2010-10-21 LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES No data
Three-digit plan number (PN) 001
Effective date of plan 2003-05-20
Business code 621111
Sponsor’s telephone number 6064519948
Plan sponsor’s address 349 BOGLE STREET, SOMERSET, KY, 42503

Plan administrator’s name and address
Administrator’s EIN 141879871
Plan administrator’s name LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES
Plan administrator’s address 349 BOGLE STREET, SOMERSET, KY, 42503
Administrator’s telephone number 6064519948
LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES 401K PLAN 2009 141879871 2011-07-18 LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES 1
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-05-20
Business code 621111
Sponsor’s telephone number 6064519948
Plan sponsor’s address 349 BOGLE STREET, SOMERSET, KY, 42503

Plan administrator’s name and address
Administrator’s EIN 141879871
Plan administrator’s name LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES
Plan administrator’s address 349 BOGLE STREET, SOMERSET, KY, 42503
Administrator’s telephone number 6064519948

Signature of
Role Plan administrator
Date 2011-07-18
Name of individual signing FRANK HARRISON
Valid signature Filed with authorized/valid electronic signature
LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES 401K PLAN 2009 141879871 2011-07-18 LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES No data
Three-digit plan number (PN) 001
Effective date of plan 2003-05-20
Business code 621111
Sponsor’s telephone number 6064519948
Plan sponsor’s address 349 BOGLE STREET, SOMERSET, KY, 42503

Plan administrator’s name and address
Administrator’s EIN 141879871
Plan administrator’s name LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES
Plan administrator’s address 349 BOGLE STREET, SOMERSET, KY, 42503
Administrator’s telephone number 6064519948

Signature of
Role Plan administrator
Date 2011-07-18
Name of individual signing FRANK HARRISON
Valid signature Filed with authorized/valid electronic signature
LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES 401K PLAN 2009 141879871 2011-07-18 LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES No data
Three-digit plan number (PN) 001
Effective date of plan 2003-05-20
Business code 621111
Sponsor’s telephone number 6064519948
Plan sponsor’s address 349 BOGLE STREET, SOMERSET, KY, 42503

Plan administrator’s name and address
Administrator’s EIN 141879871
Plan administrator’s name LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES
Plan administrator’s address 349 BOGLE STREET, SOMERSET, KY, 42503
Administrator’s telephone number 6064519948

Signature of
Role Plan administrator
Date 2011-07-18
Name of individual signing ROBERT CAMERON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-18
Name of individual signing ROBERT CAMERON
Valid signature Filed with authorized/valid electronic signature
LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES DEFINED BENEFIT PLAN & TRUST 2009 141879871 2010-10-15 LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2006-01-01
Business code 621111
Sponsor’s telephone number 6064519448
Plan sponsor’s address 349 BOGLE STREET, SOMERSET, KY, 42501

Plan administrator’s name and address
Administrator’s EIN 141879871
Plan administrator’s name LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES
Plan administrator’s address 349 BOGLE STREET, SOMERSET, KY, 42501
Administrator’s telephone number 6064519448

Signature of
Role Plan administrator
Date 2010-10-15
Name of individual signing DR. ROBERT CAMERON
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2010-10-15
Name of individual signing DR. ROBERT CAMERON
Valid signature Filed with authorized/valid electronic signature
Three-digit plan number (PN) 001
Effective date of plan 2003-05-20
Business code 621111
Sponsor’s telephone number 6064519948
Plan sponsor’s address 349 BOGLE STREET, SOMERSET, KY, 42503

Plan administrator’s name and address
Administrator’s EIN 141879871
Plan administrator’s name LAKE CUMBERLAND CARDIOVASCULAR ASSOCIATES
Plan administrator’s address 349 BOGLE STREET, SOMERSET, KY, 42503
Administrator’s telephone number 6064519948

Signature of
Role Plan administrator
Date 2010-10-09
Name of individual signing FRANK HARRISON
Valid signature Filed with authorized/valid electronic signature

Registered Agent

Name Role
JOSEPH C BENTON ESQUIRE Registered Agent

Manager

Name Role
Robert W Cameron Manager

Organizer

Name Role
ROBERT W CAMERON MD Organizer

Filings

Name File Date
Administrative Dissolution 2014-09-30
Annual Report 2013-07-19
Annual Report 2012-04-05
Annual Report 2011-03-30
Annual Report 2010-03-31
Annual Report 2009-07-22
Annual Report Amendment 2008-04-30
Annual Report 2008-04-15
Annual Report 2007-01-15
Annual Report 2006-02-09

Related by officers

JOSEPH C BENTON ESQUIRE

WIRELESS SECURITY USA, LLC

Related by address

349 BOGLE STREET, SOMERSET, KY 42503

R SQUARED ENTERPRISES, LLC

Date of last update: 10 Nov 2024

Sources: Kentucky Secretary of State

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