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BERT FISH MEDICAL CENTER, INC. - Florida Company Profile

Company Details

Entity Name: BERT FISH MEDICAL CENTER, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
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: 13 Mar 1995 (30 years ago)
Last Event: AMENDED AND RESTATED ARTICLES
Event Date Filed: 28 Jun 2011 (14 years ago)
Document Number: N95000001178
FEI/EIN Number 593306983

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

Address: 909 Carey Drive, South Daytona, FL, 32119, US
Mail Address: PO BOX 909, NEW SMYRNA BEACH, FL, 32170, US
ZIP code: 32119
County: Volusia
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1245275734 2006-06-18 2015-05-15 401 PALMETTO ST, P.O. BOX 1350, NEW SMYRNA BEACH, FL, 321687322, US 401 PALMETTO ST, NEW SMYRNA BEACH, FL, 321687322, US

Contacts

Phone +1 386-424-5000

Authorized person

Name MR. AL ALLRED
Role CFO
Phone 3864245261

Taxonomy

Taxonomy Code 282N00000X - General Acute Care Hospital
License Number 4054
State FL
Is Primary Yes

Other Provider Identifiers

Issuer MEDICAID
Number 010183400
State FL

Legal Entity Identifier

LEI number Registered As Jurisdiction Of Formation General Category Entity Status Entity created at
549300KH311MT8TXEY22 N95000001178 US-FL GENERAL ACTIVE -

Addresses

Legal C/O Steve Harrell, 401 Palmetto Street, New Smyrna Beach, US-FL, US, 32168
Headquarters 401 Palmetto Street, New Smyrna Beach, US-FL, US, 32168

Registration details

Registration Date 2013-03-22
Last Update 2023-08-04
Status LAPSED
Next Renewal 2015-03-07
LEI Issuer 5493001KJTIIGC8Y1R12
Corroboration Level FULLY_CORROBORATED
Data Validated As N95000001178

Key Officers & Management

Name Role Address
Card Harold Secretary 3019 WILLOW OAK DRIVE, EDGEWATER, FL, 32141
PRESTON WILLIAM Chairman 605 SOUTH ORANGE STREET, NEW SMYRNA BEACH, FL, 32168
DAVIDSON JEFF Chief Financial Officer 305 MAGNOLIA STREET, NEW SMYRNA BEACH, FL, 32168
DAVIDSON JEFF Agent 909 Carey Drive, South Daytona, FL, 32119

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G15000011910 BFMC COMMUNITY HEALTH CENTER EXPIRED 2015-02-03 2020-12-31 - 401 PALMETTO STREET, NEW SMYRNA BEACH, FL, 32168
G11000050281 BERT FISH EDGEWATER IMAGING AND DIAGNOSTIC CENTER EXPIRED 2011-05-27 2016-12-31 - 239 N. RIDGEWOOD AVENUE, EDGEWATER, FL, 32132
G11000048975 BERT FISH MEDICAL CENTER ACTIVE 2011-05-24 2026-12-31 - PO BOX 909, NEW SMYRNA BEACH, FL, 32170, US
G08042900615 CORONADO RHEUMATOLOGY CARE EXPIRED 2008-02-11 2013-12-31 - 401 PALMETTO STREET, NEW SMYRNA BEACH, FL, 32168

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2021-03-12 909 Carey Drive, South Daytona, FL 32119 -
CHANGE OF PRINCIPAL ADDRESS 2021-03-12 909 Carey Drive, South Daytona, FL 32119 -
REGISTERED AGENT NAME CHANGED 2017-10-19 DAVIDSON, JEFF -
CHANGE OF MAILING ADDRESS 2016-08-30 909 Carey Drive, South Daytona, FL 32119 -
AMENDED AND RESTATEDARTICLES 2011-06-28 - -
MERGER 2010-07-01 - CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 900000106039
RESTATED ARTICLES 2010-07-01 - -
AMENDMENT 1995-06-30 - -

Documents

Name Date
ANNUAL REPORT 2024-02-05
ANNUAL REPORT 2023-01-30
ANNUAL REPORT 2022-03-08
ANNUAL REPORT 2021-03-12
ANNUAL REPORT 2020-05-19
ANNUAL REPORT 2019-03-27
ANNUAL REPORT 2018-01-15
Reg. Agent Change 2017-10-19
Reg. Agent Change 2017-07-28
ANNUAL REPORT 2017-01-10

OSHA's Inspections within Industry

Inspection Nr Report ID Date Opened Site Address
341027373 0419700 2015-10-30 401 PALMETTO STREET, NEW SMYRNA, FL, 32168
Inspection Type Complaint
Scope Complete
Safety/Health Health
Close Conference 2015-10-30
Case Closed 2015-11-12

Related Activity

Type Complaint
Activity Nr 1027576
Safety Yes
Health Yes
339744260 0419700 2014-04-25 713 LIVE OAK STREET, NEW SMYRNA BEACH, FL, 32168
Inspection Type Complaint
Scope Partial
Safety/Health Health
Close Conference 2014-04-25
Case Closed 2014-07-11

Related Activity

Type Complaint
Activity Nr 881215
Health Yes

Tax Exempt

EIN Type of Organization Exempt Organization Status Address Ruling Date
59-3306983 Corporation Unconditional Exemption PO BOX 909, NEW SMYRNA, FL, 32170-0909 1995-10
In Care of Name -
Group Exemption Number 0000
Subsection Charitable Organization, Educational Organization, Literary Organization, Organization to Prevent Cruelty to Animals, Organization to Prevent Cruelty to Children, Organization for Public Safety Testing, Religious Organization, Scientific Organization
Affiliation Central - This code is used if the organization is a central type organization (no group exemption) of a National, Regional or Geographic grouping of organizations.
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)
Deductibility Contributions are deductible.
Foundation Hospital or medical research organization 170(b)(1)(A)(iii)
Tax Period 2011-06
Asset 50,000,000 to greater
Income 50,000,000 to greater
Filing Requirement 990 - Not required to file (instrumentalities of states or political subdivisions)
PF Filing Requirement No 990-PF return
Accounting Period Jun
Asset Amount 83210197
Income Amount 71517904
Form 990 Revenue Amount 71187356
National Taxonomy of Exempt Entities -
Sort Name -

Publication 78 Data

Description Organizations eligible to receive tax-deductible charitable contributions. Users may rely on this list in determining deductibility of their contributions.
On Publication 78 Data List Yes
Deductibility Type of organization and use of contribution: A public charity. Deductibility Limitation: 50% (60% for cash contributions)

Date of last update: 02 Apr 2025

Sources: Florida Department of State