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ONE SOURCE MEDICAL GROUP, LLC - Florida Company Profile

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Company Details

Entity Name: ONE SOURCE MEDICAL GROUP, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 18 May 2007 (18 years ago)
Last Event: LC STMNT OF RA/RO CHG
Event Date Filed: 05 Jun 2017 (8 years ago)
Document Number: L07000053246
FEI/EIN Number 26-0159522
Address: 13910 LYNMAR BLVD, TAMPA, FL, 33626, US
Mail Address: 13910 LYNMAR BLVD, TAMPA, FL, 33626, US
ZIP code: 33626
City: Tampa
County: Hillsborough
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
- Agent -
Mueller Robert Vice President 13910 Lynmar Blvd, Tampa, FL, 33626
Sternberg Eric Chief Operating Officer 13910 Lynmar Blvd, Tampa, FL, 33626
Robichaud Jon President 13910 Lynmar Blvd, Tampa, FL, 33626

Unique Entity ID

Unique Entity ID:
MM23GAENU8W3
CAGE Code:
7PA41
UEI Expiration Date:
2026-04-18

Business Information

Activation Date:
2025-04-23
Initial Registration Date:
2016-08-02

Commercial and government entity program

CAGE number:
7PA41
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2025-04-23
CAGE Expiration:
2030-04-23
SAM Expiration:
2026-04-18

Contact Information

POC:
DANIEL JON ROBICHAUD

National Provider Identifier

NPI Number:
1366653545
Certification Date:
2022-08-24

Authorized Person:

Name:
DANIEL J ROBICHAUD
Role:
CEO
Phone:

Taxonomy:

Selected Taxonomy:
332BP3500X - Parenteral & Enteral Nutrition Supplies (DME)
Is Primary:
No
Selected Taxonomy:
332B00000X - Durable Medical Equipment & Medical Supplies
Is Primary:
Yes

Contacts:

Fax:
8774909111

Form 5500 Series

Employer Identification Number (EIN):
260159522
Plan Year:
2023
Number Of Participants:
53
Sponsors Telephone Number:
Plan Year:
2022
Number Of Participants:
54
Sponsors Telephone Number:
Plan Year:
2021
Number Of Participants:
45
Sponsors Telephone Number:
Plan Year:
2019
Number Of Participants:
51
Sponsors Telephone Number:
Plan Year:
2018
Number Of Participants:
46
Sponsors Telephone Number:

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2018-05-15 13910 LYNMAR BLVD, TAMPA, FL 33626 -
CHANGE OF MAILING ADDRESS 2018-05-15 13910 LYNMAR BLVD, TAMPA, FL 33626 -
LC STMNT OF RA/RO CHG 2017-06-05 - -
REGISTERED AGENT ADDRESS CHANGED 2017-06-05 6930 W LINEBAUGH AVE, TAMPA, FL 33625 -
LC AMENDMENT 2015-11-02 - -
REGISTERED AGENT NAME CHANGED 2015-11-02 FRESH LEGAL PERSPECTIVE, PL -

Documents

Name Date
ANNUAL REPORT 2024-03-15
AMENDED ANNUAL REPORT 2023-10-16
ANNUAL REPORT 2023-03-27
ANNUAL REPORT 2022-03-30
ANNUAL REPORT 2021-04-07
ANNUAL REPORT 2020-01-16
ANNUAL REPORT 2019-02-06
ANNUAL REPORT 2018-04-23
CORLCRACHG 2017-06-05
AMENDED ANNUAL REPORT 2017-03-18

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Date of last update: 02 Aug 2025

Sources: Florida Department of State