| Entity Name: | CCI BILLING SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 01 Jun 2007 (18 years ago) |
| Date of dissolution: | 18 Apr 2013 (12 years ago) |
| Last Event: | WITHDRAWAL |
| Event Date Filed: | 18 Apr 2013 (12 years ago) |
| Document Number: | M07000003309 |
| FEI/EIN Number | 208315149 |
| Address: | 92 E MCNAB RD, POMPANO BEACH, FL, 33060 |
| Mail Address: | 1121 N BETHLEHEM PIKE, SUITE 60-234, SPRING HOUSE, PA, 19477, US |
| ZIP code: | 33060 |
| County: | Broward |
| Place of Formation: | TEXAS |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1528109485 | 2007-02-12 | 2008-08-26 | 92 E MCNAB RD, POMPANO BEACH, FL, 330609238, US | 1500 LEE BLVD, LEHIGH ACRES, FL, 339364835, US | |||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 954-545-0337 |
| Fax | 9545453497 |
| Phone | +1 239-368-4517 |
Authorized person
| Name | CHARLES TRENTHAM |
| Role | OWNER |
| Phone | 9545450337 |
Taxonomy
| Taxonomy Code | 163W00000X - Registered Nurse |
| Is Primary | Yes |
| Taxonomy Code | 207L00000X - Anesthesiology Physician |
| Is Primary | No |
| Taxonomy Code | 367500000X - Certified Registered Nurse Anesthetist |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 278080100 |
| State | FL |
| Issuer | WORKMANS COMP |
| Number | 612438900 |
| State | FL |
| Issuer | RAILROAD MEDICARE |
| Number | DG2104 |
| State | FL |
| Issuer | BLUE CROSS |
| Number | 99300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| TRENTHAM CHARLES MD | Manager | 92 E MCNAB RD, POMPANO BEACH, FL, 33060 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| WITHDRAWAL | 2013-04-18 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-18 | 92 E MCNAB RD, POMPANO BEACH, FL 33060 | No data |
| CANCEL ADM DISS/REV | 2008-10-29 | No data | No data |
| REVOKED FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| Name | Date |
|---|---|
| WITHDRAWAL | 2013-04-18 |
| ANNUAL REPORT | 2012-02-08 |
| ANNUAL REPORT | 2011-04-22 |
| ANNUAL REPORT | 2010-03-30 |
| ANNUAL REPORT | 2009-04-29 |
| REINSTATEMENT | 2008-10-29 |
| Foreign Limited | 2007-06-01 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
