| Entity Name: | ARA-WEST JACKSONVILLE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Nov 2001 (23 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 18 May 2022 (3 years ago) |
| Document Number: | L01000019345 |
| FEI/EIN Number | 02-0538733 |
| Address: | 500 Cummings Center, Beverly, MA, 01915, US |
| Mail Address: | 425 N Lee Street, Jacksonville, FL, 32204-1128, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093730806 | 2006-07-13 | 2023-01-10 | 425 N LEE ST, SUITE 103, JACKSONVILLE, FL, 322041128, US | 425 N LEE ST, SUITE 103, JACKSONVILLE, FL, 322041128, US | |||||||||||||||||||||
|
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| Phone | +1 904-598-2711 |
| Fax | 9045982712 |
Authorized person
| Name | SARA ANNE BRADY |
| Role | CHIEF NURSING OFFICER |
| Phone | 2083717878 |
Taxonomy
| Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 890100700 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| Baker III James DM.D. | Member | 500 Cummings Center, Beverly, MA, 01915 |
| Smart James BJr. M.D | Member | 500 Cummings Center, Beverly, MA, 01915 |
| Michal David H | Member | 500 Cummings Center, Beverly, MA, 01915 |
| AMERICAN RENAL ASSOCIATES LLC | Member | No data |
| Name | Role | Address |
|---|---|---|
| Kamal Syed T | Manager | 500 Cummings Center, Beverly, MA, 01915 |
| Mendez Nick | Manager | 1550 W. MCEWEN DR.,, FRANKLIN, TN, 37067 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-02-22 | 500 Cummings Center, Suite 6550, Beverly, MA 01915 | No data |
| CHANGE OF MAILING ADDRESS | 2023-02-22 | 500 Cummings Center, Suite 6550, Beverly, MA 01915 | No data |
| LC STMNT OF RA/RO CHG | 2022-05-18 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-05-18 | CORPORATION SERVICE COMPANY | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-05-18 | 1201 HAYS STREET, TALLAHASSEE, FL 32301 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-24 |
| ANNUAL REPORT | 2024-02-23 |
| ANNUAL REPORT | 2023-02-22 |
| CORLCRACHG | 2022-05-18 |
| ANNUAL REPORT | 2022-04-11 |
| ANNUAL REPORT | 2021-04-17 |
| ANNUAL REPORT | 2020-06-03 |
| ANNUAL REPORT | 2019-03-19 |
| ANNUAL REPORT | 2018-04-06 |
| ANNUAL REPORT | 2017-04-17 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
