| Entity Name: | PUTNAM COMMUNITY MEDICAL CENTER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 19 Apr 2000 (25 years ago) |
| Date of dissolution: | 01 May 2015 (10 years ago) |
| Last Event: | LC WITHDRAWAL |
| Event Date Filed: | 01 May 2015 (10 years ago) |
| Document Number: | M00000000770 |
| FEI/EIN Number | 621818453 |
| Address: | 330 Seven Springs Way, Brentwood, TN, 37027, US |
| Mail Address: | 330 Seven Springs Way, Brentwood, TN, 37027, US |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295154185 | 2014-04-08 | 2014-04-08 | 611 ZEAGLER DR, PALATKA, FL, 321773810, US | 611 ZEAGLER DR, PALATKA, FL, 321773810, US | |||||||||||||||||||||||
|
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| Phone | +1 386-326-8450 |
| Fax | 3863268484 |
Authorized person
| Name | GAIL KING |
| Role | DIRECTOR OF PHARMACY |
| Phone | 3863268451 |
Taxonomy
| Taxonomy Code | 3336I0012X - Institutional Pharmacy |
| License Number | PH17363 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2145072 |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| Bivacca Donald J | Manager | 330 Seven Springs Way, Brentwood, TN, 37027 |
| Teague Kathy | Manager | 330 Seven Springs Way, Brentwood, TN, 37027 |
| Frantz Steve W | Manager | 330 Seven Springs Way, Brentwood, TN, 37027 |
| Owens Bradley R | Manager | 330 Seven Springs Way, Brentwood, TN, 37027 |
| Coggin Michael S | Manager | 330 Seven Springs Way, Brentwood, TN, 37027 |
| Green Christy J | Manager | 330 Seven Springs Way, Brentwood, TN, 37027 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC WITHDRAWAL | 2015-05-01 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-04-12 | 330 Seven Springs Way, Brentwood, TN 37027 | No data |
| CHANGE OF MAILING ADDRESS | 2015-04-12 | 330 Seven Springs Way, Brentwood, TN 37027 | No data |
| REGISTERED AGENT NAME CHANGED | 2002-01-22 | C T CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2002-01-22 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| LC Withdrawal | 2015-05-01 |
| ANNUAL REPORT | 2015-04-12 |
| ANNUAL REPORT | 2014-05-01 |
| ANNUAL REPORT | 2013-01-30 |
| ANNUAL REPORT | 2012-01-05 |
| ANNUAL REPORT | 2011-01-13 |
| ANNUAL REPORT | 2010-04-06 |
| ANNUAL REPORT | 2009-03-18 |
| ANNUAL REPORT | 2008-04-30 |
| ANNUAL REPORT | 2007-04-18 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
