| Entity Name: | EDGEWOOD NURSING CENTER, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 15 Mar 2002 (23 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | P02000028809 |
| FEI/EIN Number | 02-0564394 |
| Address: | 995 Canton St., Suite 100, Roswell, GA 30075 |
| Mail Address: | 995 CANTON ST., SUITE 100, ROSWELL, GA 30075 |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962404905 | 2005-08-10 | 2019-07-18 | 995 CANTON ST STE 100, ROSWELL, GA, 300754240, US | 1771 EDGEWOOD AVE W, JACKSONVILLE, FL, 322083278, US | |||||||||||||||||||||||
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| Phone | +1 770-993-4000 |
| Fax | 9047665749 |
| Phone | +1 904-766-7436 |
Authorized person
| Name | ROBERT HAGAN |
| Role | PRESIDENT |
| Phone | 7709934000 |
Taxonomy
| Taxonomy Code | 314000000X - Skilled Nursing Facility |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 025487800 |
| State | FL |
| Name | Role |
|---|---|
| REGISTERED AGENTS INC | Agent |
| Name | Role | Address |
|---|---|---|
| HAGAN, ROBERT W | President | 995 CANTON STREET, SUITE 100 ROSWELL, GA 30075 |
| Name | Role | Address |
|---|---|---|
| HAGAN, ROBERT W | Chief Financial Officer | 995 CANTON STREET, SUITE 100 ROSWELL, GA 30075 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-04-21 | 995 Canton St., Suite 100, Roswell, GA 30075 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-03-25 | 7901 4TH STREET NORTH, SUITE 300, ST.PETERSBURG, FL 33702 | No data |
| CHANGE OF MAILING ADDRESS | 2016-03-29 | 995 Canton St., Suite 100, Roswell, GA 30075 | No data |
| REGISTERED AGENT NAME CHANGED | 2014-04-14 | Registered Agents Inc. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-04-21 |
| ANNUAL REPORT | 2021-04-14 |
| ANNUAL REPORT | 2020-06-11 |
| ANNUAL REPORT | 2019-04-12 |
| ANNUAL REPORT | 2018-03-09 |
| ANNUAL REPORT | 2017-04-05 |
| ANNUAL REPORT | 2016-03-29 |
| ANNUAL REPORT | 2015-04-08 |
| ANNUAL REPORT | 2014-04-14 |
| ANNUAL REPORT | 2013-04-23 |
Date of last update: 31 Jan 2025
Sources: Florida Department of State
