| Entity Name: | TRELLES MEMORIAL CLINIC AND HOSPITAL, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 29 Dec 1952 (72 years ago) |
| Document Number: | 171693 |
| FEI/EIN Number | 590688520 |
| Address: | 2915 W. HILLSBOROUGH AVE.,, TAMPA FLA, 33614-6054 |
| Mail Address: | 2915 W. HILLSBOROUGH AVE.,, TAMPA FLA, 33614-6054 |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1184624843 | 2005-07-26 | 2020-08-22 | P.O. BOX 89039-0400, TAMPA, FL, 336899039, US | 3501 RIGA BLVD, SUITE 300B, TAMPA, FL, 336191333, US | |||||||||||||||||||||||||
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| Phone | +1 813-662-1153 |
| Fax | 8136573475 |
Authorized person
| Name | MR. JAMES CLEAVER RICHARDSON |
| Role | OWNER/PRESIDENT |
| Phone | 8136621153 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | PH11093 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NCPDP |
| Number | 1068558 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| THOMAS S. RUTHERFORD, R.A. | Agent | 11016 N. DALE MABRY HWY., #201, TAMPA, FL, 33618 |
| Name | Role | Address |
|---|---|---|
| PATEL PRADIP C | Director | 11010 N. DALE NABRY HWY., #203, TAMPA, FL, 33618 |
| Name | Role | Address |
|---|---|---|
| PATEL PRADIP C | President | 11010 N. DALE NABRY HWY., #203, TAMPA, FL, 33618 |
| Name | Role | Address |
|---|---|---|
| PATEL PRADIP C | Secretary | 11010 N. DALE NABRY HWY., #203, TAMPA, FL, 33618 |
| Name | Role | Address |
|---|---|---|
| PATEL PRADIP C | Treasurer | 11010 N. DALE NABRY HWY., #203, TAMPA, FL, 33618 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1998-10-16 | No data | No data |
| REINSTATEMENT | 1997-12-10 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1995-08-25 | No data | No data |
| AMENDMENT | 1986-06-19 | No data | No data |
| NAME CHANGE AMENDMENT | 1963-12-03 | TRELLES MEMORIAL CLINIC AND HOSPITAL, INC. | No data |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
