| Entity Name: | HOSPICE OF THE EMERALD COAST, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Non-Profit |
| Status: | Active |
| Date Filed: | 13 Dec 1999 (25 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 09 Jan 2009 (16 years ago) |
| Document Number: | N99000007332 |
| FEI/EIN Number | 62-1805874 |
| Address: | 655 Brawley School Road, Suite 200, Mooresville, NC, 28117, US |
| Mail Address: | 655 Brawley School Road, Suite 200, Mooresville, NC, 28117, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1952337149 | 2006-06-23 | 2022-10-10 | PO BOX 4060, MOORESVILLE, NC, 281174060, US | 401 E 23RD ST STE C, PANAMA CITY, FL, 324057616, US | |||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||
| Phone | +1 704-664-2876 |
| Fax | 7046641306 |
| Phone | +1 850-769-0055 |
| Fax | 8507690321 |
Authorized person
| Name | JANET COMBS |
| Role | VP, OF LICENSURE |
| Phone | 9138142013 |
Taxonomy
| Taxonomy Code | 251G00000X - Community Based Hospice Care Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | G2 |
| Number | U35 |
| Issuer | MEDICAID |
| Number | 150009100 |
| State | FL |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| Blanchard Cathy | Vice Chairman | 655 Brawley School Road, Mooresville, NC, 28117 |
| Name | Role | Address |
|---|---|---|
| Griswold Sarah | Treasurer | 655 Brawley School Road, Mooresville, NC, 28117 |
| Name | Role | Address |
|---|---|---|
| Combs Janet | Secretary | 655 Brawley School Road, Mooresville, NC, 28117 |
| Name | Role | Address |
|---|---|---|
| Eidt Angela | Vice President | 655 Brawley School Road, Mooresville, NC, 28117 |
| Name | Role | Address |
|---|---|---|
| Long William | Director | 655 Brawley School Road, Mooresville, NC, 28117 |
| Name | Role | Address |
|---|---|---|
| Cutler Andrew | President | 655 Brawley School Road, Mooresville, NC, 28117 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G07088900260 | EMERALD COAST HOSPICE | ACTIVE | 2007-03-29 | 2028-12-31 | No data | 655 BRAWLEY SCHOOL RD, SUITE 200, MOORESVILLE, NC, 29117 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-05-01 | 655 Brawley School Road, Suite 200, Mooresville, NC 28117 | No data |
| CHANGE OF MAILING ADDRESS | 2024-05-01 | 655 Brawley School Road, Suite 200, Mooresville, NC 28117 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-02-18 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| REGISTERED AGENT NAME CHANGED | 2015-02-18 | C T CORPORATION SYSTEM | No data |
| REINSTATEMENT | 2009-01-09 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| AMENDMENT | 2004-07-30 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-01 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-04-26 |
| ANNUAL REPORT | 2021-02-22 |
| ANNUAL REPORT | 2020-05-27 |
| ANNUAL REPORT | 2019-01-22 |
| ANNUAL REPORT | 2018-04-09 |
| ANNUAL REPORT | 2017-01-30 |
| ANNUAL REPORT | 2016-02-03 |
| ANNUAL REPORT | 2015-04-24 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
