| Entity Name: | HEALTHSTAT PENSACOLA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 06 Jun 2011 (14 years ago) |
| Date of dissolution: | 09 Jun 2023 (2 years ago) |
| Last Event: | LC WITHDRAWAL |
| Event Date Filed: | 09 Jun 2023 (2 years ago) |
| Document Number: | M11000002875 |
| FEI/EIN Number |
45-2451706
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4651 Charlotte Park Drive, Charlotte, NC, 28217, US |
| Mail Address: | 4651 Charlotte Park Drive, Charlotte, NC, 28217, US |
| Place of Formation: | NORTH CAROLINA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053606988 | 2011-06-20 | 2011-10-04 | 4601 CHARLOTTE PARK DR, SUITE 390, CHARLOTTE, NC, 282171915, US | 1678 AIRPORT BLVD, PENSACOLA, FL, 325048618, US | |||||||||||||||||||||||
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| Phone | +1 704-529-6161 |
| Fax | 7049365570 |
| Phone | +1 850-479-3790 |
| Fax | 8504793920 |
Authorized person
| Name | SUSAN KINZLER |
| Role | EVP SALES & MARKETING |
| Phone | 7045296161 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 5706657 |
| Name | Role | Address |
|---|---|---|
| MILLER CHRIS | President | 1400 Wewatta Street, Denver, CO, 80202 |
| DIXON HEATHER | Treasurer | 400 Wewatta Street, Denver, CO, 80202 |
| TSUDA MICHI | Secretary | 1400 Wewatta Street, Denver, CO, 80202 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G12000007244 | HEALTHSTAT | EXPIRED | 2012-01-20 | 2017-12-31 | - | 4601 CHARLOTTE PARK DRIVE, SUITE 390, CHARLOTTE, NC, 28217 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT CHANGED | 2023-06-09 | REGISTERED AGENT REVOKED | - |
| WITHDRAWAL | 2023-06-09 | - | - |
| LC WITHDRAWAL | 2023-06-09 | - | - |
| REINSTATEMENT | 2023-06-09 | - | - |
| REVOKED FOR ANNUAL REPORT | 2022-09-23 | - | - |
| CHANGE OF MAILING ADDRESS | 2018-04-23 | 4651 Charlotte Park Drive, Suite 300, Charlotte, NC 28217 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2018-04-23 | 4651 Charlotte Park Drive, Suite 300, Charlotte, NC 28217 | - |
| REINSTATEMENT | 2013-07-29 | - | - |
| REVOKED FOR ANNUAL REPORT | 2012-09-28 | - | - |
| Name | Date |
|---|---|
| REINSTATEMENT | 2023-06-09 |
| WITHDRAWAL | 2023-06-09 |
| ANNUAL REPORT | 2021-04-27 |
| ANNUAL REPORT | 2020-04-13 |
| ANNUAL REPORT | 2019-04-17 |
| ANNUAL REPORT | 2018-04-23 |
| ANNUAL REPORT | 2017-04-14 |
| ANNUAL REPORT | 2016-04-26 |
| ANNUAL REPORT | 2015-04-29 |
| ANNUAL REPORT | 2014-05-01 |
Date of last update: 02 Mar 2025
Sources: Florida Department of State
