| Entity Name: | DESLOGE HOME OXYGEN AND MEDICAL EQUIPMENT, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 01 Jun 1989 (36 years ago) |
| Document Number: | K91930 |
| FEI/EIN Number | 592962517 |
| Address: | 220 W GERMANTOWN PK #250, PLYMOUTH MEETING, PA, 19462, US |
| Mail Address: | 220 W GERMANTOWN PK #250, PLYMOUTH MEETING, PA, 19462, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1164412664 | 2005-10-26 | 2021-09-30 | 3325 BARTLETT BLVD, ORLANDO, FL, 328116428, US | 1611 JAYDELL CIR, TALLAHASSEE, FL, 32308, US | |||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||
| Phone | +1 407-206-0040 |
| Fax | 4072060040 |
| Phone | +1 850-656-8900 |
| Fax | 8509420220 |
Authorized person
| Name | STEPHEN P GRIGGS |
| Role | CEO |
| Phone | 4072060040 |
Taxonomy
| Taxonomy Code | 332BX2000X - Oxygen Equipment & Supplies (DME) |
| License Number | 326429 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 671041701 |
| State | FL |
| Issuer | MEDICAID |
| Number | 009315800 |
| State | FL |
| Name | Role |
|---|---|
| UNITED CORPORATE SERVICES, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| CLEMENS JASON | Treasurer | 220 W GERMANTOWN PK #250, PLYMOUTH MEETING, PA, 19462 |
| Name | Role | Address |
|---|---|---|
| Russalesi Wendy | CHIE | 220 W GERMANTOWN PIKE SUITE 250, PLYMOUTH MEETING, PA, 19462 |
| Name | Role | Address |
|---|---|---|
| Foster Suzanne | President | 220 W GERMANTOWN PK #250, PLYMOUTH MEETING, PA, 19462 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2013-01-30 | No data | No data |
| MERGER | 2000-12-29 | No data | CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 0. MERGER NUMBER 700000033817 |
| AMENDMENT AND NAME CHANGE | 2000-08-15 | DESLOGE HOME OXYGEN AND MEDICAL EQUIPMENT, INC. | No data |
| AMENDMENT AND NAME CHANGE | 1996-04-29 | TOTAL MEDICAL CARE, INC. | No data |
| NAME CHANGE AMENDMENT | 1991-02-12 | TALLAHASSEE MEDICAL CORPORATION | No data |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
