| Entity Name: | PERITONEAL DIALYSIS SUPPLY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 30 Dec 2002 (22 years ago) |
| Date of dissolution: | 24 Sep 2010 (14 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 24 Sep 2010 (14 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 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1275526113 | 2005-08-25 | 2008-04-10 | 1964 BAYSHORE BLVD SUITE C, DUNEDIN, FL, 346982576, US | 1964 BAYSHORE BLVD, SUITE C, DUNEDIN, FL, 346982576, US | |||||||||||||||||
|
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| Phone | +1 727-738-5255 |
| Fax | 7277330431 |
Authorized person
| Name | MRS. JUNE A. CLARK |
| Role | BUSINESS MANAGER |
| Phone | 7277385255 |
Taxonomy
| Taxonomy Code | 332BD1200X - Dialysis Equipment & Supplies (DME) |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| CLARK JUNE A | Agent | 1964 BAYSHORE BLVD., DUNEDIN, FL, 34698 |
| 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 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-05-01 | 1964 BAYSHORE BLVD., SUITE C, DUNEDIN, FL 34698 | No data |
| AMENDMENT | 2005-12-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-06-22 | 1964 BAYSHORE BLVD UNIT C, DUNEDIN, FL 34698 | No data |
| CHANGE OF MAILING ADDRESS | 2005-06-22 | 1964 BAYSHORE BLVD UNIT C, DUNEDIN, FL 34698 | No data |
| REINSTATEMENT | 2003-12-05 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2003-12-05 | CLARK, JUNE A | No data |
| AMENDMENT | 2003-12-05 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-26 | No data | No data |
| 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 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
