| Name: | GREEN RIVER ORAL SURGERY LLC |
| Jurisdiction: | Kentucky |
| Profit or Non-Profit: | Profit |
| Legal type: | Kentucky Limited Liability Company |
| Status: | Active |
| Standing: | Good |
| File Date: | 27 Jun 2012 (12 years ago) |
| Organization Date: | 27 Jun 2012 (12 years ago) |
| Organization Number: | 0832370 |
| Industry: | Health Services |
| Number of Employees: | Small (0-19) |
| Primary County: | Henderson |
| Place of Formation: | KENTUCKY |
| Last Annual Report: | 19 Aug 2024 (3 months ago) |
| Managed By: | Members |
| Principal Office: | 801 NORTH ELM STREET, HENDERSON, KY 42420 |
| Principal Office ZIP code: | 42420 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| GREEN RIVER ORAL SURGERY CBS BENEFIT PLAN | 2022 | 455573261 | 2023-12-27 | GREEN RIVER ORAL SURGERY | 3 | |||||||||||||||||||||||||||||||
|
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| Administrator’s EIN | 846429706 |
| Plan administrator’s name | SHAWNA BURTON |
| Plan administrator’s address | 464 CHENAULT RD, FRANKFORT, KY, 40601 |
| Administrator’s telephone number | 5026954700 |
Signature of
| Role | Plan administrator |
| Date | 2023-12-27 |
| Name of individual signing | SHAWNA BURTON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 501 |
| Effective date of plan | 2020-09-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 2702120330 |
| Plan sponsor’s address | 801 N ELM ST, HENDERSON, KY, 42420 |
Plan administrator’s name and address
| Administrator’s EIN | 846429706 |
| Plan administrator’s name | SHAWNA BURTON |
| Plan administrator’s address | 464 CHENAULT RD, FRANKFORT, KY, 40601 |
| Administrator’s telephone number | 5026954700 |
Signature of
| Role | Plan administrator |
| Date | 2022-12-29 |
| Name of individual signing | SHAWNA BURTON |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 501 |
| Effective date of plan | 2020-09-01 |
| Business code | 621210 |
| Sponsor’s telephone number | 2702120330 |
| Plan sponsor’s address | 801 N ELM ST, HENDERSON, KY, 42420 |
Plan administrator’s name and address
| Administrator’s EIN | 846429706 |
| Plan administrator’s name | SHAWNA BURTON |
| Plan administrator’s address | 464 CHENAULT RD, FRANKFORT, KY, 40601 |
| Administrator’s telephone number | 5026954700 |
Signature of
| Role | Plan administrator |
| Date | 2021-12-14 |
| Name of individual signing | SHAWNA BURTON |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| ROBERT G WAGONER | Registered Agent |
| Name | Role |
|---|---|
| ROBERT G WAGONER | Member |
| Name | Role |
|---|---|
| ROBERT G WAGONER | Organizer |
| Name | File Date |
|---|---|
| Annual Report | 2024-08-19 |
| Annual Report | 2023-06-05 |
| Annual Report | 2022-06-01 |
| Annual Report | 2021-04-16 |
| Annual Report | 2020-06-16 |
| Annual Report | 2019-06-06 |
| Annual Report | 2018-06-07 |
| Annual Report | 2017-06-06 |
| Annual Report | 2016-07-06 |
| Annual Report | 2015-06-05 |
Date of last update: 14 Nov 2024
Sources: Kentucky Secretary of State
