UNITED CLINICS OF KENTUCKY, LLC

Business Information

Division Name	UNITED CLINICS OF KENTUCKY
Congressional District	06
State/Country of Incorporation	KY, USA
Activation Date	2021-06-17
Initial Registration Date	2021-06-11
Entity Start Date	2004-04-14
Fiscal Year End Close Date	Dec 31

Points of Contacts

Electronic Business
Title	PRIMARY POC
Name	PHILLIP WHITE
Role	DIRECTOR OF OPERATIONS
Address	PO BOX 220, CAMPTON, KY, 41301, USA

Government Business
Title	PRIMARY POC
Name	PHILLIP WHITE
Role	DIRECTOR OF OPERATIONS
Address	PO BOX 220, CAMPTON, KY, 41301, USA

Past Performance	Information not Available

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-01-01
Business code	621111
Sponsor’s telephone number	6066686932
Plan sponsor’s address	239 MOUNTAIN PARKWAY SPUR, CAMPTON, KY, 413018988

Signature of

Role	Plan administrator
Date	2024-09-25
Name of individual signing	PHILLIP WHITE
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2024-09-16
Name of individual signing	PHILLIP WHITE
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-01-01
Business code	621111
Sponsor’s telephone number	6066686932
Plan sponsor’s address	239 MOUNTAIN PARKWAY SPUR, CAMPTON, KY, 413018988

Signature of

Role	Plan administrator
Date	2023-07-06
Name of individual signing	PHILLIP WHITE
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2023-07-06
Name of individual signing	PHILLIP WHITE
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-01-01
Business code	621111
Sponsor’s telephone number	6066686932
Plan sponsor’s address	239 MOUNTAIN PARKWAY SPUR, CAMPTON, KY, 413018988

Signature of

Role	Plan administrator
Date	2022-07-14
Name of individual signing	PHILLIP WHITE
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2022-07-14
Name of individual signing	PHILLIP WHITE
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-01-01
Business code	621111
Sponsor’s telephone number	6066686932
Plan sponsor’s address	239 MOUNTAIN PARKWAY SPUR, CAMPTON, KY, 413018988

Signature of

Role	Plan administrator
Date	2021-09-29
Name of individual signing	PHILLIP WHITE
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2021-09-29
Name of individual signing	PHILLIP WHITE
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-01-01
Business code	621111
Sponsor’s telephone number	6066686932
Plan sponsor’s address	239 MOUNTAIN PARKWAY SPUR, CAMPTON, KY, 413018988

Signature of

Role	Plan administrator
Date	2020-07-27
Name of individual signing	PHILLIP WHITE
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-01-01
Business code	621111
Sponsor’s telephone number	6066686932
Plan sponsor’s address	239 MOUNTAIN PARKWAY SPUR, CAMPTON, KY, 40591

Signature of

Role	Plan administrator
Date	2019-07-18
Name of individual signing	PHILLIP WHITE
Valid signature	Filed with authorized/valid electronic signature
Role	Employer/plan sponsor
Date	2019-07-18
Name of individual signing	PHILLIP WHITE
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-01-01
Business code	621111
Sponsor’s telephone number	6066686932
Plan sponsor’s address	239 MOUNTAIN PARKWAY SPUR, CAMPTON, KY, 40591

Signature of

Role	Plan administrator
Date	2018-10-12
Name of individual signing	PHILLIP WHITE
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-01-01
Business code	621111
Sponsor’s telephone number	6066686932
Plan sponsor’s address	239 MOUNTAIN PARKWAY SPUR, CAMPTON, KY, 40591

Signature of

Role	Plan administrator
Date	2017-10-16
Name of individual signing	NADEEM SHAIKH, MD
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-01-01
Business code	621111
Sponsor’s telephone number	6066686932
Plan sponsor’s address	239 MOUNTAIN PARKWAY SPUR, CAMPTON, KY, 40591

Signature of

Role	Plan administrator
Date	2016-07-31
Name of individual signing	NADEEM SHAIKH, MD
Valid signature	Filed with authorized/valid electronic signature

File	View Page
Three-digit plan number (PN)	001
Effective date of plan	2010-01-01
Business code	621111
Sponsor’s telephone number	6066686932
Plan sponsor’s address	239 MOUNTAIN PARKWAY SPUR P.O. BOX, LEXINGTON, KY, 40591

Signature of

Role	Plan administrator
Date	2015-08-24
Name of individual signing	NADEEM SHAIKH, MD
Valid signature	Filed with authorized/valid electronic signature

File	https://efast2-filings-public.s3.amazonaws.com/prd/2014/10/14/20141014122341P040048338439001.pdf
Three-digit plan number (PN)	001
Effective date of plan	2010-01-01
Business code	621111
Sponsor’s telephone number	6066686932
Plan sponsor’s address	239 MOUNTAIN PARKWAY SPUR P.O. BOX, LEXINGTON, KY, 40591

Signature of

Role	Plan administrator
Date	2014-10-14
Name of individual signing	NADEEM SHAIKH, MD
Valid signature	Filed with authorized/valid electronic signature