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KENTUCKY PAIN MANAGEMENT SERVICES, LLC

Company Details

Name: KENTUCKY PAIN MANAGEMENT SERVICES, LLC
Jurisdiction: Kentucky
Profit or Non-Profit: Profit
Legal type: Kentucky Limited Liability Company
Status: Active
Standing: Good
File Date: 28 Aug 2006 (18 years ago)
Organization Date: 28 Aug 2006 (18 years ago)
Organization Number: 0645798
Industry: Hotels, Rooming Houses, Camps, and other Lodging Places
Number of Employees: Medium (20-99)
Primary County: Perry
Place of Formation: KENTUCKY
Last Annual Report: 06 Mar 2024 (8 months ago)
Managed By: Members
Principal Office: 311 ROY CAMPBELL DRIVE, HAZARD, KY 41701
Principal Office ZIP code: 41701

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KENTUCKY PAIN MANAGEMENT SERVICES 401K PLAN 2011 205350815 2012-04-27 KENTUCKY PAIN MANAGEMENT SERVICES 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 6064871137
Plan sponsor’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486

Plan administrator’s name and address
Administrator’s EIN 205350815
Plan administrator’s name KENTUCKY PAIN MANAGEMENT SERVICES
Plan administrator’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486
Administrator’s telephone number 6064871137

Signature of
Role Plan administrator
Date 2012-04-27
Name of individual signing RANDY MULLINS
Valid signature Filed with authorized/valid electronic signature
KENTUCKY PAIN MANAGEMENT SERVICES 401K PLAN 2010 205350815 2011-07-11 KENTUCKY PAIN MANAGEMENT SERVICES 24
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 6064871137
Plan sponsor’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486

Plan administrator’s name and address
Administrator’s EIN 205350815
Plan administrator’s name KENTUCKY PAIN MANAGEMENT SERVICES
Plan administrator’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486
Administrator’s telephone number 6064871137

Signature of
Role Plan administrator
Date 2011-07-11
Name of individual signing RANDY MULLINS
Valid signature Filed with authorized/valid electronic signature
KENTUCKY PAIN MANAGEMENT SERVICES 401K PLAN 2009 205350815 2010-06-22 KENTUCKY PAIN MANAGEMENT SERVICES 23
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 6064871137
Plan sponsor’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486

Plan administrator’s name and address
Administrator’s EIN 205350815
Plan administrator’s name KENTUCKY PAIN MANAGEMENT SERVICES
Plan administrator’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486
Administrator’s telephone number 6064871137

Signature of
Role Plan administrator
Date 2010-06-22
Name of individual signing P. RANDY MULLINS
Valid signature Filed with incorrect/unrecognized electronic signature
KENTUCKY PAIN MANAGEMENT SERVICES 401K PLAN 2009 205350815 2010-06-23 KENTUCKY PAIN MANAGEMENT SERVICES 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 6064871137
Plan sponsor’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486

Plan administrator’s name and address
Administrator’s EIN 205350815
Plan administrator’s name KENTUCKY PAIN MANAGEMENT SERVICES
Plan administrator’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486
Administrator’s telephone number 6064871137

Signature of
Role Plan administrator
Date 2010-06-23
Name of individual signing RANDY MULLINS
Valid signature Filed with authorized/valid electronic signature
KENTUCKY PAIN MANAGEMENT SERVICES 401K PLAN 2009 205350815 2010-06-23 KENTUCKY PAIN MANAGEMENT SERVICES 23
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 6064871137
Plan sponsor’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486

Plan administrator’s name and address
Administrator’s EIN 205350815
Plan administrator’s name KENTUCKY PAIN MANAGEMENT SERVICES
Plan administrator’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486
Administrator’s telephone number 6064871137

Signature of
Role Plan administrator
Date 2010-06-23
Name of individual signing RANDY MULLINS
Valid signature Filed with incorrect/unrecognized electronic signature
KENTUCKY PAIN MANAGEMENT SERVICES 401K PLAN 2009 205350815 2010-06-23 KENTUCKY PAIN MANAGEMENT SERVICES 23
Three-digit plan number (PN) 001
Effective date of plan 2008-01-01
Business code 621111
Sponsor’s telephone number 6064871137
Plan sponsor’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486

Plan administrator’s name and address
Administrator’s EIN 205350815
Plan administrator’s name KENTUCKY PAIN MANAGEMENT SERVICES
Plan administrator’s address 311 ROY CAMPBELL DR., HAZARD, KY, 417019486
Administrator’s telephone number 6064871137

Signature of
Role Plan administrator
Date 2010-06-23
Name of individual signing RANDY MULLINS
Valid signature Filed with incorrect/unrecognized electronic signature

Registered Agent

Name Role
RANDY MULLINS Registered Agent

Organizer

Name Role
RANDY MULLINS Organizer

Member

Name Role
RANDY MULLINS Member

Filings

Name File Date
Annual Report 2024-03-06
Annual Report 2023-03-21
Annual Report 2022-05-25
Annual Report 2021-07-08
Annual Report 2020-06-01
Annual Report 2019-06-03
Annual Report 2018-06-07
Annual Report 2017-06-20
Annual Report 2016-03-28
Annual Report 2015-06-22

Related by officers

RANDY MULLINS

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RANDY MULLINS

SIMON & TRUE MEDICAL CONSULTANTS, INC. EAST KENTUCKY PROPERTIES, LLC

Related by address

No related companies by address

Date of last update: 12 Nov 2024

Sources: Kentucky Secretary of State

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