| Entity Name: | ANDERSON KIDNEY DIALYSIS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 03 Feb 2011 (14 years ago) |
| Document Number: | M11000000521 |
| FEI/EIN Number | 274361004 |
| Mail Address: | 601 HAWAII ST, EL SEGUNDO, CA, 90245, US |
| Address: | 2000 16TH STREET, DENVER, CO, 80202, US |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1124397146 | 2011-12-20 | 2019-02-13 | 5200 VIRGINIA WAY, L&C DEPARTMENT, BRENTWOOD, TN, 370277569, US | 1122 KEY PLZ KEY PLAZA, KEY WEST, FL, 330404076, US | |||||||||||||||||||||||||
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| Phone | +1 615-320-4593 |
| Fax | 8002935872 |
| Phone | +1 305-294-8453 |
| Fax | 3052943421 |
Authorized person
| Name | JAMES K HILGER |
| Role | CHIEF ACCOUNTING OFFICER |
| Phone | 2537334500 |
Taxonomy
| Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 007321600 |
| State | FL |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| TOTAL RENAL CARE, INC. | Auth | No data |
| Caldwell Samantha A | Auth | 2000 16TH STREET, DENVER, CO, 80202 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000082298 | KEY WEST DIALYSIS | EXPIRED | 2016-08-09 | 2021-12-31 | No data | 2000 16TH STREET, ATTN JLD SECGOVFIN, DENVER, CO, 80202 |
| G11000120464 | KEY WEST DIALYSIS | EXPIRED | 2011-12-12 | 2016-12-31 | No data | 1122 N. ROOSEVELT BLVD., KEY PLAZA, KEY WEST, FL, 33040 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-14 | 2000 16TH STREET, JLD/SECGOVFIN, DENVER, CO 80202 | No data |
| CHANGE OF MAILING ADDRESS | 2023-04-14 | 2000 16TH STREET, JLD/SECGOVFIN, DENVER, CO 80202 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-19 |
| ANNUAL REPORT | 2023-04-14 |
| ANNUAL REPORT | 2022-04-19 |
| ANNUAL REPORT | 2021-04-20 |
| ANNUAL REPORT | 2020-04-20 |
| ANNUAL REPORT | 2019-04-15 |
| ANNUAL REPORT | 2018-04-13 |
| ANNUAL REPORT | 2017-04-19 |
| ANNUAL REPORT | 2016-04-19 |
| ANNUAL REPORT | 2015-04-28 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
