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  5. COASTAL HEALTH SYSTEMS OF BREVARD, INC.

COASTAL HEALTH SYSTEMS OF BREVARD, INC.

Company Details

Entity Name: COASTAL HEALTH SYSTEMS OF BREVARD, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active
Date Filed: 02 Sep 1988 (36 years ago)
Document Number: N28193
FEI/EIN Number 592908075
Address: 486 GUS HIPP BLVD., ROCKLEDGE, FL, 32955, US
Mail Address: P.O. BOX 560750, ROCKLEDGE, FL, 32956-0750, US
ZIP code: 32955
County: Brevard
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1235103029 2006-02-16 2020-08-22 486 GUS HIPP BLVD, ROCKLEDGE, FL, 329554800, US 486 GUS HIPP BLVD, ROCKLEDGE, FL, 329554800, US

Contacts
Phone +1 321-633-7050
Fax 3216323005

Authorized person
Name MR. WILLIAM D MCCARTHY
Role CEO
Phone 3216337050

Taxonomy
Taxonomy Code 3416L0300X - Land Ambulance
License Number 002591
State FL
Is Primary Yes

Other Provider Identifiers
Issuer AMBULANCE
Number A0608
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
COASTAL HEALTH SYSTEMS OF BREVARD, INC 401(K) PROFIT SHARING PLAN AND TRUST 2022 592908075 2023-06-23 COASTAL HEALTH SYSTEMS OF BREVARD, INC 85
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-10-01
Business code 485990
Sponsor’s telephone number 3216337050
Plan sponsor’s address 486 GUS HIPP BLVD, ROCKLEDGE, FL, 329554800

Signature of
Role Plan administrator
Date 2023-06-23
Name of individual signing BROOKE TAYLOR
Valid signature Filed with authorized/valid electronic signature
COASTAL HEALTH SYSTEMS 401(K) PLAN 2014 592908075 2015-11-16 COASTAL HEALTH SYSTEMS OF BREVARD, INC. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-10-01
Business code 485990
Sponsor’s telephone number 3216337050
Plan sponsor’s address 486 GUS HIPP BLVD, ROCKLEDGE, FL, 32955

Signature of
Role Plan administrator
Date 2015-11-16
Name of individual signing COASTALBILL1
Valid signature Filed with authorized/valid electronic signature
COASTAL HEALTH SYSTEMS LOCAL I.A.E.P. 401(K) PLAN 2014 592908075 2018-07-04 COASTAL HEALTH SYSTEMS OF BREVARD, INC. 56
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-10-01
Business code 621900
Sponsor’s telephone number 3216337050
Plan sponsor’s address 486 GUS HIPP BLVD, ROCKLEDGE, FL, 32955

Signature of
Role Plan administrator
Date 2018-07-04
Name of individual signing WILLLIAM MCCARTHY
Valid signature Filed with authorized/valid electronic signature
COASTAL HEALTH SYSTEMS LOCAL I.A.E.P. 401(K) PLAN 2014 592908075 2015-11-20 COASTAL HEALTH SYSTEMS OF BREVARD, INC. 56
Three-digit plan number (PN) 002
Effective date of plan 2000-10-01
Business code 621900
Sponsor’s telephone number 3216337050
Plan sponsor’s address 486 GUS HIPP BLVD, ROCKLEDGE, FL, 32955

Signature of
Role Plan administrator
Date 2015-11-20
Name of individual signing COASTALBILL1
Valid signature Filed with authorized/valid electronic signature
COASTAL HEALTH SYSTEMS OF BREVARD, INC. 2013 592908075 2015-07-16 COASTAL HEALTH SYSTEMS OF BREVARD, INC. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-10-01
Business code 485990
Sponsor’s telephone number 3216337050
Plan sponsor’s address 486 GUS HIPP BLVD, ROCKLEDGE, FL, 32955

Signature of
Role Plan administrator
Date 2015-07-16
Name of individual signing COASTALBILL1
Valid signature Filed with authorized/valid electronic signature
COASTAL HEALTH SYSTEMS LOCAL I.A.E.P. 401(K) PLAN 2013 592908075 2015-01-19 COASTAL HEALTH SYSTEMS OF BREVARD, INC. 66
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2000-10-01
Business code 621900
Sponsor’s telephone number 3216337050
Plan sponsor’s address 486 GUS HIPP BLVD, ROCKLEDGE, FL, 32955

Signature of
Role Plan administrator
Date 2015-01-19
Name of individual signing WILLIAM MCCARTHY
Valid signature Filed with authorized/valid electronic signature
COASTAL HEALTH SYSTEMS 401K PLAN 2012 592908075 2013-12-26 COASTAL HEALTH SYSTEMS OF BREVARD INC. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-10-01
Business code 485990
Sponsor’s telephone number 3216337050
Plan sponsor’s address P O BOX 560750, ROCKLEDGE, FL, 329560750

Signature of
Role Plan administrator
Date 2013-12-26
Name of individual signing WILLIAM MCCARTHY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-12-26
Name of individual signing WILLIAM MCCARTHY
Valid signature Filed with authorized/valid electronic signature
COASTAL HEALTH SYSTEMS 401K PLAN 2011 592908075 2013-04-18 COASTAL HEALTH SYSTEMS OF BREVARD INC. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-10-01
Business code 485990
Sponsor’s telephone number 3216337050
Plan sponsor’s address P O BOX 560750, ROCKLEDGE, FL, 329560750

Plan administrator’s name and address
Administrator’s EIN 592908075
Plan administrator’s name COASTAL HEALTH SYSTEMS OF BREVARD INC.
Plan administrator’s address P O BOX 560750, ROCKLEDGE, FL, 329560750
Administrator’s telephone number 3216337050

Signature of
Role Plan administrator
Date 2013-04-18
Name of individual signing WILLIAM MCCARTHY
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-04-18
Name of individual signing WILLIAM MCCARTHY
Valid signature Filed with authorized/valid electronic signature
COASTAL HEALTH SYSTEMS 401K PLAN 2010 592908075 2011-11-10 COASTAL HEALTH SYSTEMS OF BREVARD INC. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-10-01
Business code 485990
Sponsor’s telephone number 3216337050
Plan sponsor’s address P O BOX 560750, ROCKLEDGE, FL, 329560750

Plan administrator’s name and address
Administrator’s EIN 592908075
Plan administrator’s name COASTAL HEALTH SYSTEMS OF BREVARD INC.
Plan administrator’s address P O BOX 560750, ROCKLEDGE, FL, 329560750
Administrator’s telephone number 3216337050

Signature of
Role Plan administrator
Date 2011-11-10
Name of individual signing WILLIAM MCCARTHY
Valid signature Filed with authorized/valid electronic signature
COASTAL HEALTH SYSTEMS 401K PLAN 2009 592908075 2010-10-22 COASTAL HEALTH SYSTEMS OF BREVARD INC. 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2000-10-01
Business code 485990
Sponsor’s telephone number 3216337050
Plan sponsor’s address P O BOX 560750, ROCKLEDGE, FL, 329560750

Plan administrator’s name and address
Administrator’s EIN 592908075
Plan administrator’s name COASTAL HEALTH SYSTEMS OF BREVARD INC.
Plan administrator’s address P O BOX 560750, ROCKLEDGE, FL, 329560750
Administrator’s telephone number 3216337050

Signature of
Role Plan administrator
Date 2010-10-22
Name of individual signing WILLIAM MCCARTHY
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
Taylor A BPreside Agent 2535 Summer Brook Street, Melbourne, FL, 32940

Treasurer

Name Role Address
VAN LEEUWEN MONICA Treasurer 486 GUS HIPP BLVD., ROCKLEDGE, FL, 32955

Director

Name Role Address
Graybill Matthew F Director 951 N. WASHINGTON AVE, Titusville, FL, 32796
Tobin Christine Director 1350 S. Hickory Street, Melbourne, FL, 32901
Bassani Tiffany Director 330 S. Fiske Blvd., Rockledge, FL, 32955
MCALPINE CHRISTOPHER Director 951 N. WASHINGTON AVE, TITUSVILLE, FL, 32796

Secretary

Name Role Address
Pierce Jeanne Secretary 486 Gus Hipp Blvd, Rockledge, FL, 32955

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G96110000039 COASTAL AMBULANCE SERVICE ACTIVE 1996-04-19 2026-12-31 No data 486 GUS HIPP BLVD, ROCKLEDGE, FL, 32955
G91113000134 COASTAL TRANSPORTATION SERVICES ACTIVE 1991-04-23 2026-12-31 No data 486 GUS HIPP BLVD, ROCKLEDGE, FL, 32955

Events

Event Type Filed Date Value Description
AMENDED AND RESTATEDARTICLES 2011-06-08 No data No data
AMENDED AND RESTATEDARTICLES 2001-04-17 No data No data
AMENDMENT 1993-12-02 No data No data
AMENDED AND RESTATEDARTICLES 1991-10-08 No data No data
AMENDED AND RESTATEDARTICLES 1988-11-29 No data No data

Awards

Contract Type Award or IDV Flag PIID Start Date Current End Date Potential End Date
DELIVERY ORDER AWARD 36C24825N0027 2024-10-01 2025-09-30 2025-09-30
Unique Award Key CONT_AWD_36C24825N0027_3600_36C24823D0014_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 380000.00
Current Award Amount 380000.00
Potential Award Amount 380000.00

Description
Title NON-EMERGENCY GROUND AMBULANCE TRANSPORTATION
NAICS Code 621910: AMBULANCE SERVICES
Product and Service Codes V225: TRANSPORTATION/TRAVEL/RELOCATION- TRAVEL/LODGING/RECRUITMENT: AMBULANCE

Recipient Details
Recipient COASTAL HEALTH SYSTEMS OF BREVARD, INC
UEI H9LWE3VNPAY1
Recipient Address UNITED STATES, 486 GUS HIPP BLVD, ROCKLEDGE, BREVARD, FLORIDA, 329554800
DELIVERY ORDER AWARD 36C24824N0064 2023-10-01 2024-09-30 2024-09-30
Unique Award Key CONT_AWD_36C24824N0064_3600_36C24823D0014_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 470000.00
Current Award Amount 470000.00
Potential Award Amount 470000.00

Description
Title NON-EMERGENCY GROUND AMBULANCE TRANSPORTATION
NAICS Code 621910: AMBULANCE SERVICES
Product and Service Codes V225: TRANSPORTATION/TRAVEL/RELOCATION- TRAVEL/LODGING/RECRUITMENT: AMBULANCE

Recipient Details
Recipient COASTAL HEALTH SYSTEMS OF BREVARD, INC
UEI H9LWE3VNPAY1
Recipient Address UNITED STATES, 486 GUS HIPP BLVD, ROCKLEDGE, BREVARD, FLORIDA, 329554800
DELIVERY ORDER AWARD 36C24823N0074 2022-10-01 2023-09-30 2023-09-30
Unique Award Key CONT_AWD_36C24823N0074_3600_36C24823D0014_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 140629.48
Current Award Amount 140629.48
Potential Award Amount 140629.48

Description
Title NON-EMERGENCY GROUND AMBULANCE TRANSPORTATION
NAICS Code 621910: AMBULANCE SERVICES
Product and Service Codes V225: TRANSPORTATION/TRAVEL/RELOCATION- TRAVEL/LODGING/RECRUITMENT: AMBULANCE

Recipient Details
Recipient COASTAL HEALTH SYSTEMS OF BREVARD, INC
UEI H9LWE3VNPAY1
Recipient Address UNITED STATES, 486 GUS HIPP BLVD, ROCKLEDGE, BREVARD, FLORIDA, 329554800
No data IDV 36C24823D0014 2022-10-01 No data No data
Unique Award Key CONT_IDV_36C24823D0014_3600
Awarding Agency Department of Veterans Affairs
Link View Page

Award Amounts
Obligated Amount 0.00
Potential Award Amount 3000000.00

Description
Title OY2 NON-EMERGENCY GROUND AMBULANCE TRANSPORTATION
NAICS Code 621910: AMBULANCE SERVICES
Product and Service Codes V225: TRANSPORTATION/TRAVEL/RELOCATION- TRAVEL/LODGING/RECRUITMENT: AMBULANCE

Recipient Details
Recipient COASTAL HEALTH SYSTEMS OF BREVARD, INC
UEI H9LWE3VNPAY1
Recipient Address UNITED STATES, 486 GUS HIPP BLVD, ROCKLEDGE, BREVARD, FLORIDA, 329554800

Related by officers

MCALPINE CHRISTOPHER

CENTURY MEDICAL PLAZA ASSOCIATION, INC. HOSPICE OF ST. FRANCIS, INC. DIALYSIS AND KIDNEY CENTER OF NORTH BREVARD, INC. TITUSVILLE FAMILY PRACTICE CENTER, P.A.

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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