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PERITONEAL DIALYSIS SUPPLY, LLC - Florida Company Profile

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Company Details

Entity Name: PERITONEAL DIALYSIS SUPPLY, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Inactive
Date Filed: 30 Dec 2002 (23 years ago)
Date of dissolution: 24 Sep 2010 (15 years ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 24 Sep 2010 (15 years ago)
Document Number: L02000035104
FEI/EIN Number 542088490
Address: 1964 BAYSHORE BLVD UNIT C, DUNEDIN, FL, 34698
Mail Address: 1964 BAYSHORE BLVD UNIT C, DUNEDIN, FL, 34698
ZIP code: 34698
City: Dunedin
County: Pinellas
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
CAMPBELL DANA A Manager 1964 BAYSHORE BLVD UNIT C, DUNEDIN, FL, 34698
RABADI KHALED Manager 1964 BAYSHORE BLVD UNIT C, DUNEDIN, FL, 34698
ROBARDS MICHAEL Manager 1964 BAYSHORE BLVD UNIT C, DUNEDIN, FL, 34698
RUSSO MARK S Manager 1964 BAYSHORE BLVD UNIT C, DUNEDIN, FL, 34698
CLARK JUNE A Manager 1964 BAYSHORE BLVD. STE C, DUNEDIN, FL, 34698
CLARK JUNE A Agent 1964 BAYSHORE BLVD., DUNEDIN, FL, 34698

National Provider Identifier

NPI Number:
1275526113

Authorized Person:

Name:
MRS. JUNE A. CLARK
Role:
BUSINESS MANAGER
Phone:

Taxonomy:

Selected Taxonomy:
332BD1200X - Dialysis Equipment & Supplies (DME)
Is Primary:
Yes

Contacts:

Fax:
7277330431

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2010-09-24 - -
REGISTERED AGENT ADDRESS CHANGED 2006-05-01 1964 BAYSHORE BLVD., SUITE C, DUNEDIN, FL 34698 -
AMENDMENT 2005-12-28 - -
CHANGE OF PRINCIPAL ADDRESS 2005-06-22 1964 BAYSHORE BLVD UNIT C, DUNEDIN, FL 34698 -
CHANGE OF MAILING ADDRESS 2005-06-22 1964 BAYSHORE BLVD UNIT C, DUNEDIN, FL 34698 -
REINSTATEMENT 2003-12-05 - -
REGISTERED AGENT NAME CHANGED 2003-12-05 CLARK, JUNE A -
AMENDMENT 2003-12-05 - -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2003-09-26 - -

Documents

Name Date
ANNUAL REPORT 2009-04-30
ANNUAL REPORT 2008-04-26
ANNUAL REPORT 2007-04-30
ANNUAL REPORT 2006-05-01
Amendment 2005-12-28
ANNUAL REPORT 2005-01-29
ANNUAL REPORT 2004-02-27
REINSTATEMENT 2003-12-05
Amendment 2003-12-05
Florida Limited Liabilites 2002-12-30

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Date of last update: 02 Jul 2025

Sources: Florida Department of State