| Entity Name: | FRIDLEY ROEMER HCS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 10 Apr 2000 (25 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | P00000038357 |
| FEI/EIN Number | 593640199 |
| Address: | 644 FLORIDA AVE., UNIT E, PANAMA CITY, FL, 32401 |
| Mail Address: | 644 FLORIDA AVE., UNIT E, PANAMA CITY, FL, 32401 |
| ZIP code: | 32401 |
| County: | Bay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1205807914 | 2006-01-30 | 2022-07-21 | 644 FLORIDA AVE, UNIT E, PANAMA CITY, FL, 324016355, US | 644 FLORIDA AVE, UNIT E, PANAMA CITY, FL, 324016355, US | |||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 850-896-1387 |
Authorized person
| Name | DR. LINDA ROEMER |
| Role | OWNER/PROVIDER |
| Phone | 8508961387 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| License Number | NP1376612 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MSC. IDENTIFIER STATE LIC |
| Number | 1376612 |
| State | FL |
| Issuer | STATE LICENSE # |
| Number | R49453 |
| State | NM |
| Issuer | BLUE CROSS BLUE SHIELD |
| Number | Y6683 |
| State | FL |
| Issuer | MEDICAID |
| Number | 00200184549 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ROEMER LINDA | Agent | 644 FLORIDA, PANAMA CITY, FL, 32401 |
| Name | Role | Address |
|---|---|---|
| ROEMER LINDA | Director | 644 FLORIDA AVE. UNIT E, PANAMA CITY, FL, 32401 |
| Name | Role | Address |
|---|---|---|
| FRIDLEY CLAUDE R | Manager | 644 FLORIDA AVE. UNIT E, PANAMA CITY, FL, 32401 |
| FRIDLEY CULLEN M | Manager | 510 AVERY ST, CLEVELAND, MS, 38732 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-08-08 | 644 FLORIDA AVE., UNIT E, PANAMA CITY, FL 32401 | No data |
| CHANGE OF MAILING ADDRESS | 2006-08-08 | 644 FLORIDA AVE., UNIT E, PANAMA CITY, FL 32401 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2005-04-25 | 644 FLORIDA, UNIT E, PANAMA CITY, FL 32401 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-04-16 |
| ANNUAL REPORT | 2010-04-22 |
| ANNUAL REPORT | 2009-05-01 |
| ANNUAL REPORT | 2008-05-05 |
| ANNUAL REPORT | 2007-04-18 |
| ANNUAL REPORT | 2006-08-08 |
| ANNUAL REPORT | 2005-04-25 |
| ANNUAL REPORT | 2004-04-30 |
| ANNUAL REPORT | 2003-03-26 |
| ANNUAL REPORT | 2002-02-24 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
