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  5. 904 HEALTH, INC

904 HEALTH, INC - Florida Company Profile

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Company Details

Entity Name: 904 HEALTH, INC
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active
Date Filed: 08 Apr 2022 (3 years ago)
Document Number: N22000004004
FEI/EIN Number 88-2746803
Address: 221 N. HOGAN, SUITE 118, JACKSONVILLE, FL, 32202, US
Mail Address: 221 N. HOGAN STREET, SUITE 118, JACKSONVILLE, FL, 32202, US
ZIP code: 32202
City: Jacksonville
County: Duval
Place of Formation: FLORIDA

Links between entities

Type:
Headquarter of
Company Number:
001-200-473
State:
ALABAMA
ALABAMA profile:
904 HEALTH, INC (AL)

Key Officers & Management

Name Role Address
CANNON LYDIA Director 221 N. HOGAN STREET, SUITE 118, JACKSONVILLE, FL, 32202
VIDAL NANA STONE Director 221 N. HOGAN STREET, SUITE 118, JACKSONVILLE, FL, 32202
McKAGUE MELISSA Admi 221 N. HOGAN STREET, JACKSONVILLE, FL, 32202
RASCOE VALMA Director 221 N Hogan St, Suite 118, JACKSONVILLE, FL, 32202
TARVER JAMES Agent 221 N. HOGAN STREET, JACKSONVILLE, FL, 32202
TARVER JAMES Director 221 N. HOGAN STREET, SUITE 118, JACKSONVILLE, FL, 32202

National Provider Identifier

NPI Number:
1184305435
Certification Date:
2025-02-04
Link:
View on NPI website

Authorized Person:

Name:
JAMES TARVER
Role:
DIRECTOR
Phone:
9044032079

Taxonomy:

Selected Taxonomy:
251K00000X - Public Health or Welfare Agency
Is Primary:
No
Selected Taxonomy:
261QC1500X - Community Health Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QH0100X - Health Service Clinic/Center
Is Primary:
No
Selected Taxonomy:
261QP2300X - Primary Care Clinic/Center
Is Primary:
No
Selected Taxonomy:
207RI0200X - Infectious Disease Physician
Is Primary:
Yes

Contacts:

Phone:
+1 904-900-1513
Fax:
9045754944
Phone:
+1 904-659-2475

Documents

Name Date
ANNUAL REPORT 2024-04-22
ANNUAL REPORT 2023-04-27
Domestic Non-Profit 2022-04-08

Tax Exempt

Employer Identification Number (EIN) :
88-2746803
Classification:
Government Instrumentality, Title-Holding Corporation, Charitable Organization, Agricultural Organization, Board of Trade, Pleasure, Recreational, or Social Club, Fraternal Beneficiary Society, Order or Association, Voluntary Employees' Beneficiary Association (Non-Govt. Emps.), Domestic Fraternal Societies and Associations, Teachers Retirement Fund Assoc., Benevolent Life Insurance Assoc., Burial Association, Credit Union, Mutual Insurance Company or Assoc. Other Than Life or Marine, Corp. Financing Crop Operations, Supplemental Unemployment Compensation Trust or Plan, Employee Funded Pension Trust (Created Before 6/25/59), Post or Organization of War Veterans, Legal Service Organization, Black Lung Trust, Multiemployer Pension Plan, Veterans Assoc. Formed Prior to 1880, Trust Described in Sect. 4049 of ERISA, Title Holding Co. for Pensions, etc., State-Sponsored High Risk Health Insurance Organizations, State-Sponsored Workers' Compensation Reinsurance, ACA 1322 Qualified Nonprofit Health Insurance Issuers, Apostolic and Religious Org. (501(d)), Cooperative Hospital Service Organization (501(e)), Cooperative Service Organization of Operating Educational Organization (501(f)), Child Care Organization (501(k)), Charitable Risk Pool, Qualified State-Sponsored Tuition Program, 4947(a)(1) - Private Foundation (Form 990PF Filer)
Ruling Date:
2022-11
National Taxonomy Of Exempt Entities:
Health Care: Public Health Program (Includes General Health and Wellness Promotion Services)
Deductibility:
Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Determination Letters

Link:
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Date of last update: 02 Aug 2025

Sources: Florida Department of State

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