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PSHS ALPHA PARTNERS, LLC

Company Details

Entity Name: PSHS ALPHA PARTNERS, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 01 May 2024 (9 months ago)
Last Event: CONVERSION
Event Date Filed: 01 May 2024 (9 months ago)
Document Number: L24000196932
FEI/EIN Number 650793962
Mail Address: 340 Seven Springs Way, Brentwood, TN, 37027, US
Address: 7408 Lake Worth Rd, Lake Worth, FL, 33467, US
ZIP code: 33467
County: Palm Beach
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1033106612 2005-09-29 2024-05-09 7408 LAKE WORTH RD STE 900, LAKE WORTH, FL, 334672502, US 7408 LAKE WORTH RD STE 900, LAKE WORTH, FL, 334672502, US

Contacts

Phone +1 561-433-5700
Fax 5614335901

Authorized person

Name JENNIFER B. BALDOCK
Role OFFICER AND AUTHORIZED OFFICIAL
Phone 6152345954

Taxonomy

Taxonomy Code 261QA1903X - Ambulatory Surgical Clinic/Center
License Number 1069
State FL
Is Primary Yes

Other Provider Identifiers

Issuer US DEPT OF LABOR
Number 170233100
State FL
Issuer MEDICAID
Number 0705721-00
State FL
Issuer BLUE CROSS BLUE SHIELD
Number 67G
State FL

Agent

Name Role
CORPORATION SERVICE COMPANY Agent

Authorized Member

Name Role Address
BALDOCK JENNIFER Authorized Member 340 SEVEN SPRINGS WAY SUITE 600, BRENTWOOD, TN, 37027

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-05-13 7408 Lake Worth Rd, Suite 900, Lake Worth, FL 33467 No data
CHANGE OF MAILING ADDRESS 2024-05-13 7408 Lake Worth Rd, Suite 900, Lake Worth, FL 33467 No data
CONVERSION 2024-05-01 No data CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS A97000001254. CONVERSION NUMBER 900000253259

Documents

Name Date
Florida Limited Liability 2024-05-01

Date of last update: 01 Feb 2025

Sources: Florida Department of State