| Entity Name: | MEDSTAR HOME HEALTH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 12 Aug 2013 (11 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 10 Jan 2025 (16 days ago) |
| Document Number: | L13000113664 |
| FEI/EIN Number | 46-3433197 |
| Address: | 500 West Main Street, Louisville, KY 40202 |
| Mail Address: | 500 West Main Street, Louisville, KY 40202 |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1538598081 | 2013-11-05 | 2022-08-29 | 1645 PALM BEACH LAKES BLVD STE 1100, WEST PALM BEACH, FL, 334012218, US | 1645 PALM BEACH LAKES BLVD STE 700, WEST PALM BEACH, FL, 334012213, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 561-697-3606 |
| Fax | 5616973614 |
| Phone | +1 561-904-6564 |
| Fax | 5619046575 |
Authorized person
| Name | SUSAN NORTHOVER |
| Role | SVP COMPLIANCE |
| Phone | 5616973606 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| License Number | 299991617 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICARE PTAN |
| Number | 107714 |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| Nichols, John | Authorized Signatory | 500 West Main Street, Louisville, KY 40202 |
| Name | Role | Address |
|---|---|---|
| Nichols, John | Licensure and Certification | 500 West Main Street, Louisville, KY 40202 |
| Name | Role | Address |
|---|---|---|
| Ruschell, Joseph Matthew | Vice President | 500 West Main Street, Louisville, KY 40202 |
| Marcoux Jr., Robert Martin | Vice President | 500 West Main Street, Louisville, KY 40202 |
| Name | Role | Address |
|---|---|---|
| Ruschell, Joseph Matthew | Associate General Counsel and Corporate Secretary | 500 West Main Street, Louisville, KY 40202 |
| Name | Role | Address |
|---|---|---|
| Marcoux Jr., Robert Martin | Treasurer | 500 West Main Street, Louisville, KY 40202 |
| Name | Role | Address |
|---|---|---|
| Feld, Daniel Kevin | Associate Vice President | 500 West Main Street, Louisville, KY 40202 |
| Name | Role | Address |
|---|---|---|
| Feld, Daniel Kevin | Tax | 500 West Main Street, Louisville, KY 40202 |
| Name | Role | Address |
|---|---|---|
| Edwards, Douglas Allen | Senior Vice President | 500 West Main Street, Louisville, KY 40202 |
| Name | Role | Address |
|---|---|---|
| Edwards, Douglas Allen | Enterprise Associate | 500 West Main Street, Louisville, KY 40202 |
| Name | Role | Address |
|---|---|---|
| Edwards, Douglas Allen | Business Solutions | 500 West Main Street, Louisville, KY 40202 |
| Name | Role |
|---|---|
| TRIDENT HOME HEALTH, LLC | Member |
| Name | Role | Address |
|---|---|---|
| ALLEN, LLOYD KIRK | President | 500 WEST MAIN STREET, LOUISVILLE, KY 40202 |
| Name | Role | Address |
|---|---|---|
| ALLEN, LLOYD KIRK | Home Solutions and Manager | 500 WEST MAIN STREET, LOUISVILLE, KY 40202 |
| Name | Role | Address |
|---|---|---|
| MURPHREE, JACLYN M | VICE PRESIDENT | 500 WEST MAIN STREET, LOUISVILLE, KY 40202 |
| Name | Role | Address |
|---|---|---|
| MURPHREE, JACLYN M | Chief Financial Officer | 500 WEST MAIN STREET, LOUISVILLE, KY 40202 |
| Name | Role | Address |
|---|---|---|
| MURPHREE, JACLYN M | HOME SOLUTIONS | 500 WEST MAIN STREET, LOUISVILLE, KY 40202 |
| Name | Role | Address |
|---|---|---|
| ROBERT M. MARCOUX JR. | Manager | 500 WEST MAIN STREET, LOUISVILLE, KY 40202 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000129498 | TRILOGY HOME HEALTHCARE | ACTIVE | 2016-12-01 | 2026-12-31 | No data | 1645 PALM BEACH LAKES BLVD, SUITE 1100, WEST PALM BEACH, FL, 14 |
| G14000030554 | MEDSTAR HOME HEALTH | EXPIRED | 2014-03-26 | 2019-12-31 | No data | 2505 METROCENTRE BLVD, SUITE 203, WEST PALM BEACH, FL, 33407 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2025-01-10 | No data | No data |
| LC AMENDMENT | 2024-04-09 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2024-03-11 | 500 West Main Street, Louisville, KY 40202 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2024-03-11 | 500 West Main Street, Louisville, KY 40202 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-05-08 | C T Corporation System | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-05-08 | 1200 South Pine Island Rd, Plantation, FL 33324 | No data |
| LC AMENDMENT AND NAME CHANGE | 2013-10-21 | MEDSTAR HOME HEALTH, LLC | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-09-24 |
| AMENDED ANNUAL REPORT | 2024-09-12 |
| LC Amendment | 2024-04-09 |
| ANNUAL REPORT | 2024-03-11 |
| AMENDED ANNUAL REPORT | 2023-05-08 |
| ANNUAL REPORT | 2023-01-30 |
| ANNUAL REPORT | 2022-04-27 |
| AMENDED ANNUAL REPORT | 2021-05-01 |
| ANNUAL REPORT | 2021-01-08 |
| ANNUAL REPORT | 2020-02-12 |
Date of last update: 22 Jan 2025
Sources: Florida Department of State
