| Field | Data |
|---|---|
| EIN | 36-4879143 |
| Case Number | EO-2017286-000300 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | CLARK REGIONAL MEDICAL CENTER AUXILIARY INC |
| Organization’s Mailing Address | 175 HOSPITAL DRIVE |
| City | WINCHESTER |
| State | KY |
| ZIP | 40391 |
| Accounting period End | 12 |
| Primary contact name | KARL BLACKWELL |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
KARL BLACKWELL
PRESIDENT
114 AUGUSTA DRIVE
WINCHESTER KY 40391
KEN DOVE
VICE PRESIDENT
154 WOODFORD DRIVE
WINCHESTER KY 40391
MARTHA SHEARER
TREASURER
508 ROSEMARY DRIVE
WINCHESTER KY 40391
JENNIFER WILLIAMS
SECRETARY
2300 GAY EVANS ROAD
WINCHESTER KY 40391
SHARON GOBLE
ASSISTANT TREASURER
101 DEVONSHIRE COURT
WINCHESTER KY 40391
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 8/28/2017 |
| Organization Incorporation State | KY |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E86 - Patient Services - Entertainment, Recreation |
| Organization’s purpose | Charitable: Yes Religious: No Educational: No Scientific: No Literary: No Public Safety: No Amateur Sports: No Cruelty Prevention: No |
| Qualify For Exemption | No |
| Legislation influence | No |
| Compensation of Officer director trustee | No |
| Donation of funds | No |
| Conducting Activities Outside of United States | No |
| Financial transactions with officers | No |
| Unrelated Gross Income $1,000 or More | No |
| Gaming Activity | No |
| Disaster relief assistance | No |
| One Third Support Public | No |
| One Third Support Gifts | No |
| Benefit of College | No |
| Private Foundation 508(e) | Yes |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | |
| Signature Title | |
| Signature Date |
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