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WESTSIDE SAMARITANS CLINIC INC. - Florida Company Profile

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Company Details

Entity Name: WESTSIDE SAMARITANS CLINIC INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
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: 18 Jan 2012 (13 years ago)
Date of dissolution: 27 Sep 2024 (9 months ago)
Last Event: ADMIN DISSOLUTION FOR ANNUAL REPORT
Event Date Filed: 27 Sep 2024 (9 months ago)
Document Number: N12000000613
FEI/EIN Number 90-0786544

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

Address: 1029 NE 9th Street, Gainesville, FL, 32601, US
Mail Address: 1029 NE 9th Street, Gainesville, FL, 32601, US
ZIP code: 32601
County: Alachua
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
Steven Williams Director 2630 NW 39th Avenue, Gainesville, FL, 32605
McMahon Elizabeth Treasurer 4190 NW 50th Drive #7112, Gainesville, FL, 32606
Dixon James President 2001 SW 16th Street, Gainesville, FL, 32608
Williams Steven G Agent 2630 NW 39th Avenue, Gainesville, FL, 32605

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:
6U5Y1
Status:
Active
Type:
Non-Manufacturer
CAGE Update Date:
2023-06-23

Contact Information

POC:
ROY T. KLOSSNER
Corporate URL:
samaritansclinic.com

National Provider Identifier

NPI Number:
1851651988

Authorized Person:

Name:
DR. ROY TAYLOR KLOSSNER
Role:
DIRECTOR
Phone:

Taxonomy:

Selected Taxonomy:
261QF0400X - Federally Qualified Health Center (FQHC)
Is Primary:
No
Selected Taxonomy:
261QM1300X - Multi-Specialty Clinic/Center
Is Primary:
Yes

Contacts:

Fax:
3523339009

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G14000047434 SAMARITAN'S HEALTHCARE EXPIRED 2014-05-13 2019-12-31 - 1201 NW 64TH TERRACE, GAINESVILLE, FL, 32605

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2024-09-27 - -
REGISTERED AGENT NAME CHANGED 2020-08-04 Williams, Steven G -
REINSTATEMENT 2020-08-04 - -
REGISTERED AGENT ADDRESS CHANGED 2020-08-04 2630 NW 39th Avenue, Gainesville, FL 32605 -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2019-09-27 - -
CHANGE OF PRINCIPAL ADDRESS 2017-03-30 1029 NE 9th Street, Gainesville, FL 32601 -
CHANGE OF MAILING ADDRESS 2017-03-30 1029 NE 9th Street, Gainesville, FL 32601 -
AMENDMENT 2012-10-18 - -

Documents

Name Date
ANNUAL REPORT 2023-02-14
ANNUAL REPORT 2022-03-16
ANNUAL REPORT 2021-05-05
REINSTATEMENT 2020-08-04
ANNUAL REPORT 2018-04-30
ANNUAL REPORT 2017-03-30
ANNUAL REPORT 2016-03-17
ANNUAL REPORT 2015-02-21
ANNUAL REPORT 2014-04-08
ANNUAL REPORT 2013-03-22

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Date of last update: 02 Jun 2025

Sources: Florida Department of State