| Entity Name: | LOCUSTON 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: | 01 Nov 2017 (7 years ago) |
| Document Number: | M17000009300 |
| FEI/EIN Number |
82-3271181
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 |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770141665 | 2019-06-05 | 2024-07-24 | 5200 VIRGINIA WAY, L&C DEPARTMENT, BRENTWOOD, TN, 370277569, US | 2105 HARDEN BLVD, LAKELAND, FL, 338035918, US | |||||||||||||||||||||
|
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| Phone | +1 863-284-0534 |
| Fax | 8632841140 |
Authorized person
| Name | SAMUEL T WEY |
| Role | VP LICENSURE & CERTIFICATION |
| Phone | 6153416641 |
Taxonomy
| Taxonomy Code | 261QE0700X - End-Stage Renal Disease (ESRD) Treatment Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 105379000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| TOTAL RENAL CARE, INC. | Auth | - |
| LAKELAND REGIONAL HEALTH SYSTEMS, INC. | Auth | - |
| CENTRAL FLORIDA KIDNEY CARE, P.A. | Auth | - |
| Caldwell Samantha A | Auth | 2000 16th Street, Denver, CO, 80202 |
| CORPORATION SERVICE COMPANY | Agent | - |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000051062 | HARDEN DIALYSIS | ACTIVE | 2019-04-25 | 2029-12-31 | - | 2105 HARDEN BLVD., ATTN: JLD/SECGOVFIN., LAKELAND, FL, 33803 |
| 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 | - |
| 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 | 2018-04-17 |
| Foreign Limited | 2017-11-01 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
