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  5. NATURE COAST EMERGENCY MEDICAL FOUNDATION, INC.

NATURE COAST EMERGENCY MEDICAL FOUNDATION, INC.

Company Details

Entity Name: NATURE COAST EMERGENCY MEDICAL FOUNDATION, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Inactive
Date Filed: 07 Jun 2000 (25 years ago)
Date of dissolution: 30 Mar 2022 (3 years ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 30 Mar 2022 (3 years ago)
Document Number: N00000003887
FEI/EIN Number 651021027
Address: 3876 W COUNTRY HILL DR, LECANTO, FL, 34461, US
Mail Address: 3876 W COUNTRY HILL DR, LECANTO, FL, 34461, US
ZIP code: 34461
County: Citrus
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1316991532 2006-05-20 2020-10-28 3876 W COUNTRY HILL DR, LECANTO, FL, 344619830, US 3876 W COUNTRY HILL DR, LECANTO, FL, 344619830, US

Contacts
Phone +1 352-249-4700
Fax 3522494701

Authorized person
Name MR. SCOTT BAXTER
Role EMS CHIEF/CEO
Phone 3524960016

Taxonomy
Taxonomy Code 341600000X - Ambulance
License Number 2504
State FL
Is Primary No
Taxonomy Code 3416L0300X - Land Ambulance
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 400079000
State FL

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
6LQS4 Obsolete Non-Manufacturer 2011-12-09 2023-06-25 2022-08-30 No data

Contact Information
POC MICHAEL HALL
Phone +1 352-249-4700
Fax +1 352-249-4701
Address 3876 W COUNTRY HILL DR, LECANTO, FL, 34461 9830, UNITED STATES

Ownership of Offeror Information
Highest Level Owner Information not Available
Immediate Level Owner Information not Available
List of Offerors (0) Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
NATURE COAST EMERGENCY MEDICAL FOUNDATION INC. TAX DEFERRED ANNUITY PLAN 2015 651021027 2016-10-17 NATURE COAST EMERGENCY MEDICAL FOUNDATION INC. 113
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-10-01
Business code 621900
Sponsor’s telephone number 3522494712
Plan sponsor’s address 3876 WEST COUNTRY HILL DRIVE, LECANTO, FL, 34461

Signature of
Role Plan administrator
Date 2016-10-17
Name of individual signing LYNNETTE HOLSINGER
Valid signature Filed with authorized/valid electronic signature
NATURE COAST EMERGENCY MEDICAL FOUNDATION INC. TAX DEFERRED ANNUITY PLAN 2014 651021027 2015-10-14 NATURE COAST EMERGENCY MEDICAL FOUNDATION INC. 120
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-10-01
Business code 621900
Sponsor’s telephone number 3522494712
Plan sponsor’s address 3876 WEST COUNTRY HILL DRIVE, LECANTO, FL, 34461

Signature of
Role Plan administrator
Date 2015-10-14
Name of individual signing LYNNETTE HOLSINGER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-10-14
Name of individual signing MICHAEL HALL
Valid signature Filed with authorized/valid electronic signature
NATURE COAST EMERGENCY MEDICAL FOUNDATION INC. TAX-DEFERRED ANNUITY PLAN 2013 651021027 2014-10-02 NATURE COAST EMERGENCY MEDICAL FOUNDATION INC. 101
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-10-01
Business code 621900
Sponsor’s telephone number 3522494712
Plan sponsor’s address 3876 WEST COUNTRY HILL DRIVE, LECANTO, FL, 34461

Signature of
Role Plan administrator
Date 2014-10-02
Name of individual signing LYNNETTE HOLSINGER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-02
Name of individual signing MICHAEL HALL
Valid signature Filed with authorized/valid electronic signature
NATURE COAST EMERGENCY MEDICAL FOUNDATION INC. RETIREMENT SAVINGS PLAN 2013 651021027 2014-10-02 NATURE COAST EMERGENCY MEDICAL FOUNDATION INC. 113
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-10-01
Business code 621900
Sponsor’s telephone number 3522494712
Plan sponsor’s address 3876 WEST COUNTRY HILL DRIVE, LECANTO, FL, 34461

Signature of
Role Plan administrator
Date 2014-10-02
Name of individual signing LYNNETTE HOLSINGER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-10-02
Name of individual signing MICHAEL HALL
Valid signature Filed with authorized/valid electronic signature
NATURE COAST EMERGENCY MEDICAL FOUNDATION INC. RETIREMENT SAVINGS PLAN 2012 651021027 2013-10-15 NATURE COAST EMERGENCY MEDICAL FOUNDATION INC. 117
Three-digit plan number (PN) 002
Effective date of plan 2000-10-01
Business code 621900
Sponsor’s telephone number 3522494712
Plan sponsor’s address 3876 WEST COUNTRY HILL DRIVE, LECANTO, FL, 34461

Signature of
Role Plan administrator
Date 2013-10-15
Name of individual signing LYNNETTE HOLSINGER
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2013-10-15
Name of individual signing MICHAEL HALL
Valid signature Filed with authorized/valid electronic signature
NATURE COAST EMERGENCY MEDICAL FOUNDATION INC. RETIREMENT SAVINGS PLAN 2012 651021027 2013-10-15 NATURE COAST EMERGENCY MEDICAL FOUNDATION INC. 117
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-10-01
Business code 621900
Sponsor’s telephone number 3522494712
Plan sponsor’s address 3876 WEST COUNTRY HILL DRIVE, LECANTO, FL, 34461

Signature of
Role Plan administrator
Date 2013-10-15
Name of individual signing LYNNETTE HOLSINGER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-15
Name of individual signing MICHAEL HALL
Valid signature Filed with authorized/valid electronic signature
NATURE COAST EMERGENCY MEDICAL FOUNDATION INC. TAX DEFERRED ANNUITY PLAN 2012 651021027 2013-10-04 NATURE COAST EMERGENCY MEDICAL FOUNDATION INC. 91
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-10-01
Business code 621900
Sponsor’s telephone number 3522494712
Plan sponsor’s address 3876 WEST COUNTRY HILL DRIVE, LECANTO, FL, 34461

Signature of
Role Plan administrator
Date 2013-10-04
Name of individual signing LYNNETTE HOLSINGER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-10-04
Name of individual signing MICHAEL HALL
Valid signature Filed with authorized/valid electronic signature
NATURE COAST EMERGENCY MEDICAL FOUNDATION INC. TAX DEFERRED ANNUITY PLAN 2011 651021027 2012-07-30 NATURE COAST EMERGENCY MEDICAL FOUNDATION INC. 81
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-10-01
Business code 621900
Sponsor’s telephone number 3522494712
Plan sponsor’s address 3876 WEST COUNTRY HILL DRIVE, LECANTO, FL, 34461

Plan administrator’s name and address
Administrator’s EIN 651021027
Plan administrator’s name NATURE COAST EMERGENCY MEDICAL FOUNDATION INC.
Plan administrator’s address 3876 WEST COUNTRY HILL DRIVE, LECANTO, FL, 34461
Administrator’s telephone number 3522494712

Signature of
Role Plan administrator
Date 2012-07-30
Name of individual signing LYNNETTE HOLSINGER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-30
Name of individual signing MICHAEL HALL
Valid signature Filed with authorized/valid electronic signature
NATURE COAST EMERGENCY MEDICAL FOUNDATION INC. RETIREMENT SAVINGS PLAN 2011 651021027 2012-07-30 NATURE COAST EMERGENCY MEDICAL FOUNDATION INC. 83
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-10-01
Business code 621900
Sponsor’s telephone number 3522494712
Plan sponsor’s address 3876 WEST COUNTRY HILL DRIVE, LECANTO, FL, 34461

Plan administrator’s name and address
Administrator’s EIN 651021027
Plan administrator’s name NATURE COAST EMERGENCY MEDICAL FOUNDATION INC.
Plan administrator’s address 3876 WEST COUNTRY HILL DRIVE, LECANTO, FL, 34461
Administrator’s telephone number 3522494712

Signature of
Role Plan administrator
Date 2012-07-30
Name of individual signing LYNNETTE HOLSINGER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-07-30
Name of individual signing MICHAEL HALL
Valid signature Filed with authorized/valid electronic signature
NATURE COAST EMERGENCY MEDICAL FOUNDATION INC. TAX DEFERRED ANNUITY PLAN 2010 651021027 2011-08-24 NATURE COAST EMERGENCY MEDICAL FOUNDATION INC. 73
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-10-01
Business code 621900
Sponsor’s telephone number 3522494712
Plan sponsor’s address 3876 WEST COUNTRY HILL DRIVE, LECANTO, FL, 34461

Plan administrator’s name and address
Administrator’s EIN 651021027
Plan administrator’s name NATURE COAST EMERGENCY MEDICAL FOUNDATION INC.
Plan administrator’s address 3876 WEST COUNTRY HILL DRIVE, LECANTO, FL, 34461
Administrator’s telephone number 3522494712

Signature of
Role Plan administrator
Date 2011-08-24
Name of individual signing LYNNETTE HOLSINGER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-08-24
Name of individual signing MICHAEL HALL
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
BAXTER SCOTT C Agent 3876 W COUNTRY HILL DR, LECANTO, FL, 34461

Director

Name Role Address
DAVIS GENE Director POST OFFICE BOX 700, INVERNESS, FL, 34451
Carroll Ginger Director 502 W HIGHLAND BLVD, INVERNESS, FL, 34452
Stockton Linda Director 6201 N SUNCOAST BLVD, CRYSTAL RIVER, FL, 34428

Vice President

Name Role Address
Blue-McLean Lace Vice President 3414 S Fitch Ave, INVERNESS, FL, 34452

President

Name Role Address
HEDGES MARY President 2505 N STAMPEDE DR, BEVERLY HILLS, FL, 34465

Treasurer

Name Role Address
RUBEN BRADLEY Treasurer 2299 N OVERLOOK PATH, HERNANDO, FL, 34442

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G13000116344 NATURE COAST MEDICAL TRANSPORTATION EXPIRED 2013-11-27 2018-12-31 No data 3876 WEST COUNTRY HILL DR, LECANTO, FL, 34461
G12000102989 QUALITY EMERGENCY VEHICLES EXPIRED 2012-10-23 2017-12-31 No data 3876 WEST COUNTRY HILL DR, LECANTO, FL, 34461
G11000085673 NATURE COAST EMS EXPIRED 2011-08-30 2016-12-31 No data 3876 W. COUNTRY HILL DRIVE, LECANTO, FL, 34461-9830

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2022-03-30 No data No data
REGISTERED AGENT NAME CHANGED 2020-04-03 BAXTER, SCOTT C No data
REGISTERED AGENT ADDRESS CHANGED 2020-04-03 3876 W COUNTRY HILL DR, LECANTO, FL 34461 No data
AMENDMENT 2019-08-09 No data No data
CHANGE OF PRINCIPAL ADDRESS 2009-01-23 3876 W COUNTRY HILL DR, LECANTO, FL 34461 No data
CHANGE OF MAILING ADDRESS 2009-01-23 3876 W COUNTRY HILL DR, LECANTO, FL 34461 No data
AMENDMENT 2005-09-21 No data No data

Documents

Name Date
VOLUNTARY DISSOLUTION 2022-03-30
ANNUAL REPORT 2021-01-25
AMENDED ANNUAL REPORT 2020-04-03
Reg. Agent Resignation 2020-03-02
ANNUAL REPORT 2020-02-05
Amendment 2019-08-09
ANNUAL REPORT 2019-01-28
ANNUAL REPORT 2018-03-07
ANNUAL REPORT 2017-01-11
ANNUAL REPORT 2016-02-09

Related by officers

DAVIS GENE

NATURE COAST LAND LLC MHC SOFTWARE, INC. LAKE LIFE REALTY, LLC GENE A DAVIS LLC DAVIS MARKETING INTERNATIONAL, L.L.C. MHC ASSOCIATES, INC. 4281 CASPER COURT, INC. HARBOUR HOUSE CONDOMINIUM, INC. THE DAVIS COMPANY OF TAMPA, INC.

Stockton Linda

PASCO MEDICAL PLAZA CONDOMINIUM ASSOCIATION, INC.

BAXTER SCOTT C

XONARA LLC SEED2SEW PTY LIMITED ATF THE ANGUS ONE FAMILY TRUST LLC SCOTT BAXTER MARKETING LLC

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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