| Entity Name: | THE MEDICAL GALLERY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 16 Jul 2013 (12 years ago) |
| Document Number: | L13000100782 |
| FEI/EIN Number | 46-3200649 |
| Address: | 217 NORTH WAUKESHA ST., BONIFAY, FL, 32425, US |
| Mail Address: | 217 NORTH WAUKESHA ST., BONIFAY, FL, 32425, US |
| ZIP code: | 32425 |
| County: | Holmes |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114369907 | 2013-07-23 | 2014-08-22 | 217 N WAUKESHA ST, BONIFAY, FL, 324252245, US | 217 N WAUKESHA ST, BONIFAY, FL, 324252245, US | |||||||||||||||||||||||||||||
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| Phone | +1 850-547-6186 |
| Fax | 8558995726 |
Authorized person
| Name | MR. RYAN N HELMS |
| Role | OWNER/MANAGER |
| Phone | 8505476186 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | Yes |
| Taxonomy Code | 332BP3500X - Parenteral & Enteral Nutrition Supplies (DME) |
| Is Primary | No |
| Taxonomy Code | 332BX2000X - Oxygen Equipment & Supplies (DME) |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 010841400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HELMS RYAN N | Agent | 1934 LEWIS RD,, BONIFAY, FL, 32425 |
| Name | Role | Address |
|---|---|---|
| Helms Ryan N | Manager | 1934 Lewis Road, Bonifay, FL, 32425 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2014-01-28 | 217 NORTH WAUKESHA ST., BONIFAY, FL 32425 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-24 |
| ANNUAL REPORT | 2023-04-04 |
| ANNUAL REPORT | 2022-03-29 |
| ANNUAL REPORT | 2021-02-23 |
| ANNUAL REPORT | 2020-03-19 |
| ANNUAL REPORT | 2019-03-12 |
| ANNUAL REPORT | 2018-03-09 |
| ANNUAL REPORT | 2017-05-01 |
| ANNUAL REPORT | 2016-01-27 |
| ANNUAL REPORT | 2015-03-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
