Name: | EMPACT MIDWEST, LLC |
Jurisdiction: | Kentucky |
Profit or Non-Profit: | Profit |
Legal type: | Kentucky Limited Liability Company |
Status: | Inactive |
Standing: | Bad |
File Date: | 16 Jun 2020 (4 years ago) |
Organization Date: | 16 Jun 2020 (4 years ago) |
Organization Number: | 1100494 |
Industry: | Health Services |
Number of Employees: | Small (0-19) |
Primary County: | Jefferson |
Place of Formation: | KENTUCKY |
Last Annual Report: | 29 Jun 2021 (3 years ago) |
Managed By: | Members |
Principal Office: | 1052 RIVA RIDGE DRIVE, DANVILLE, KY 40222 |
Principal Office ZIP code: | 40222 |
Unique Entity ID | Expiration Date | Physical Address | Mailing Address | |||||||||||||||||||||||||||||||||||||||
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XG15K9WZJJL8 | 2024-12-27 | 1052 RIVA RIDGE DR, DANVILLE, KY, 40422, 9016, USA | PO BOX 771511, CHICAGO, IL, 60677, USA | |||||||||||||||||||||||||||||||||||||||
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Congressional District | 01 |
State/Country of Incorporation | KY, USA |
Activation Date | 2024-01-01 |
Initial Registration Date | 2023-12-28 |
Entity Start Date | 2020-10-01 |
Fiscal Year End Close Date | Dec 31 |
Points of Contacts
Electronic Business | |
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Title | PRIMARY POC |
Name | GARY ABEL |
Role | ACCOUNTS RECEIVABLE |
Address | PO BOX 771511, CHICAGO, IL, 60677, USA |
Government Business | |
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Title | PRIMARY POC |
Name | GARY HAVENS |
Role | ACCOUNTS RECEIVABLE MANAGER |
Address | PO BOX 771511, CHICAGO, IL, 60677, USA |
Past Performance | Information not Available |
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Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
EMPACT MIDWEST CBS BENEFIT PLAN | 2021 | 851454774 | 2022-12-29 | EMPACT MIDWEST | 17 | |||||||||||||||||||||||||||||||
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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 | 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 | 2020-11-01 |
Business code | 621491 |
Sponsor’s telephone number | 5024453600 |
Plan sponsor’s address | 1052 RIVA RIDGE DRIVE, DANVILLE, KY, 40422 |
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 |
---|---|
S & H LEXINGTON, LLC | Registered Agent |
Name | Role |
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Eric Guerrant | Member |
Name | Role |
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ALISON M ZEITLIN | Organizer |
Name | File Date |
---|---|
Administrative Dissolution | 2022-10-04 |
Annual Report | 2021-06-29 |
Articles of Organization (LLC) | 2020-06-16 |
Date of last update: 29 Oct 2024
Sources: Kentucky Secretary of State