| Entity Name: | HISCARE CLINIC LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 25 Sep 2007 (17 years ago) |
| Date of dissolution: | 27 Sep 2013 (11 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2013 (11 years ago) |
| Document Number: | L07000097474 |
| FEI/EIN Number | 201192101 |
| Mail Address: | 4577 COLLINS RD, MARIANNA, FL, 32448, US |
| Address: | 4219 OLD COTTONDALE RD, MARIANNA, FL, 32448 |
| ZIP code: | 32448 |
| County: | Jackson |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1912251562 | 2012-11-05 | 2012-11-05 | 4577 COLLINS RD, MARIANNA, FL, 324485030, US | 4577 COLLINS RD, MARIANNA, FL, 324485030, US | |||||||||||||||||||||||||||||
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| Phone | +1 850-693-3055 |
| Fax | 8504825208 |
Authorized person
| Name | MRS. ANGELA MCFARLAND |
| Role | CEO/ADMINISTRATOR |
| Phone | 8506933055 |
Taxonomy
| Taxonomy Code | 302R00000X - Health Maintenance Organization |
| Is Primary | Yes |
| Taxonomy Code | 305R00000X - Preferred Provider Organization |
| Is Primary | No |
| Taxonomy Code | 305S00000X - Point of Service |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | HISCARE07 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MCFARLAND ANGELA G | Agent | 4577 COLLINS RD., MARIANNA, FL, 32448 |
| Name | Role | Address |
|---|---|---|
| MCFARLAND ANGELA G | Managing Member | 4577 COLLINS RD, MARIANNA, FL, 32448 |
| MCFARLAND WILLIAM D | Managing Member | 4577 COLLINS RD, MARIANNA, FL, 32448 |
| KENNERLY CANDACE M | Managing Member | 3810 BUENA VISTA - APT 19, COLUMBUS, GA, 31906 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2010-04-28 | MCFARLAND, ANGELA GCEO | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-04-28 | 4577 COLLINS RD., MARIANNA, FL 32448 | No data |
| CHANGE OF MAILING ADDRESS | 2009-04-20 | 4219 OLD COTTONDALE RD, MARIANNA, FL 32448 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2012-04-27 |
| ANNUAL REPORT | 2011-04-30 |
| ANNUAL REPORT | 2010-04-28 |
| ANNUAL REPORT | 2009-04-20 |
| ANNUAL REPORT | 2008-01-16 |
| Florida Limited Liability | 2007-09-25 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
