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MAMMOTH DIALYSIS, LLC - Florida Company Profile

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Company Details

Entity Name: MAMMOTH DIALYSIS, LLC
Jurisdiction: FLORIDA
Filing Type: Foreign Limited Liability Co.
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 18 Oct 2011 (14 years ago)
Document Number: M11000005216
FEI/EIN Number 453637644

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 2000 16th Street, JLD/SecGovFin., Denver, CO, 80202, US
Mail Address: 601 Hawaii Street, JLD/SecGovFin., El Segundo, CA, 90245, US
Place of Formation: DELAWARE

Key Officers & Management

Name Role Address
Caldwell Samantha A Auth 2000 16th Street, Denver, CO, 80202
CORPORATION SERVICE COMPANY Agent -
TOTAL RENAL CARE, INC. Manager -
Castillo Orlando MD Member 2000 16th Street, Denver, CO, 80202
Wong Lawrence MD Member 2000 16th Street, Denver, CO, 80202
Shah Jayesh Member 2000 16th Street, Denver, CO, 80202

Commercial and government entity program

The The Commercial And Government Entity Code (CAGE) is assigned by the Department of Defense's Defense Logistics Agency (DLA) and represents your company's physical address for GSA's mailings, payments, and administrative records.

Note: A CAGE Code enables a company to contract with the U.S. government, allowing bid on government contracts and to receive government payments. Also for business this means that it's a Verified business entity and Has a validated physical address.

CAGE number:
6SG51
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2025-06-03
CAGE Expiration:
2030-06-03
SAM Expiration:
2026-05-30

Contact Information

POC:
RYAN SPECK

Immediate Level Owner

Vendor Certified:
2025-06-03
CAGE number:
45JM2
Company Name:
DAVITA INC.

National Provider Identifier

NPI Number:
1275810905
Certification Date:
2023-08-08

Authorized Person:

Name:
SAMUEL T WEY
Role:
SR DIRECTOR,LICENSURE&CERTIFICATION
Phone:

Taxonomy:

Selected Taxonomy:
261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
8002935872
Fax:
8139617312

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G17000058677 CARROLLWOOD DIALYSIS ACTIVE 2017-05-25 2027-12-31 - 14358 N. DALE MABRY HWY., ATTN: JLD/SECGOVFIN., TAMPA, FL, 33618
G11000107489 CARROLLWOOD DIALYSIS EXPIRED 2011-11-03 2016-12-31 - 14358 N. DALE MABRY HIGHWAY, TAMPA, FL, 33618

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2024-04-19 2000 16th Street, JLD/SecGovFin., Denver, CO 80202 -
CHANGE OF MAILING ADDRESS 2024-04-19 2000 16th Street, JLD/SecGovFin., Denver, CO 80202 -

Documents

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 2019-04-16
ANNUAL REPORT 2018-04-16
ANNUAL REPORT 2017-04-19
ANNUAL REPORT 2016-04-21
ANNUAL REPORT 2015-04-28

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Date of last update: 02 Jul 2025

Sources: Florida Department of State