| Entity Name: | ABC HOME MEDICAL SUPPLY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Profit Corporation |
| Status: | Active |
| Date Filed: | 14 Jun 2012 (13 years ago) |
| Document Number: | F12000002491 |
| FEI/EIN Number | 51-0443844 |
| Address: | 1660 SW Saint Lucie West Blvd, Ste 200, PORT ST. LUCIE, FL 34986 |
| Mail Address: | 1660 SW Saint Lucie West Blvd, Suite 200, PORT ST. LUCIE, FL 34986 |
| ZIP code: | 34986 |
| County: | St. Lucie |
| Place of Formation: | TEXAS |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417217951 | 2012-05-17 | 2024-03-22 | PO BOX 674553, DETROIT, MI, 482674553, US | 1660 SW SAINT LUCIE WEST BLVD STE 200, PORT SAINT LUCIE, FL, 349861965, US | |||||||||||||||||||||||||
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| Phone | +1 772-232-7180 |
| Fax | 7722124904 |
| Fax | 7726075274 |
Authorized person
| Name | EMILY M VESTAL |
| Role | PRESIDENT AND DIRECTOR |
| Phone | 8668978588 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 114650200 |
| State | FL |
| Name | Role |
|---|---|
| NRAI SERVICES, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| Vestal, Emily M. | President | 1660 SW Saint Lucie West Blvd, Ste 200, PORT ST. LUCIE, FL 34986 |
| Name | Role | Address |
|---|---|---|
| Vestal, Emily M. | Director | 1660 SW Saint Lucie West Blvd, Ste 200, PORT ST. LUCIE, FL 34986 |
| Noble, Patrick C | Director | 1660 SW Saint Lucie West Blvd, Ste 200, PORT ST. LUCIE, FL 34986 |
| Finnerty, Timothy B. | Director | 1660 SW Saint Lucie West Blvd, Ste 200, PORT ST. LUCIE, FL 34986 |
| Name | Role | Address |
|---|---|---|
| Noble, Patrick C | Chief Financial Officer | 1660 SW Saint Lucie West Blvd, Ste 200, PORT ST. LUCIE, FL 34986 |
| Name | Role | Address |
|---|---|---|
| Noble, Patrick C | Vice President | 1660 SW Saint Lucie West Blvd, Ste 200, PORT ST. LUCIE, FL 34986 |
| Name | Role | Address |
|---|---|---|
| Heroux, Lise M | Secretary | 1660 SW Saint Lucie West Blvd, Ste 200, PORT ST. LUCIE, FL 34986 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-02-20 | 1660 SW Saint Lucie West Blvd, Ste 200, PORT ST. LUCIE, FL 34986 | No data |
| CHANGE OF MAILING ADDRESS | 2024-02-20 | 1660 SW Saint Lucie West Blvd, Ste 200, PORT ST. LUCIE, FL 34986 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-20 |
| AMENDED ANNUAL REPORT | 2023-03-31 |
| ANNUAL REPORT | 2023-01-27 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-02-03 |
| ANNUAL REPORT | 2020-05-19 |
| AMENDED ANNUAL REPORT | 2019-11-19 |
| AMENDED ANNUAL REPORT | 2019-09-12 |
| ANNUAL REPORT | 2019-04-01 |
| ANNUAL REPORT | 2018-02-26 |
Date of last update: 23 Jan 2025
Sources: Florida Department of State
