| Entity Name: | SOUTHERN FAMILY HEALTHCARE, P.A. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
SOUTHERN FAMILY HEALTHCARE, P.A. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| 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: | 24 May 2002 (23 years ago) |
| Last Event: | CANCEL ADM DISS/REV |
| Event Date Filed: | 24 Apr 2006 (19 years ago) |
| Document Number: | P02000058417 |
| FEI/EIN Number |
020609031
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 877 3rd Street, SUITE 4, CHIPLEY, FL, 32428, US |
| Mail Address: | P O BOX 692, CHIPLEY, FL, 32428 |
| ZIP code: | 32428 |
| County: | Washington |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154533677 | 2007-05-04 | 2017-10-18 | 877 3RD ST STE 4, CHIPLEY, FL, 324281855, US | 877 3RD ST STE 4, CHIPLEY, FL, 324281855, US | |||||||||||||||||||||||||||
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| Phone | +1 850-638-4383 |
| Fax | 8504156783 |
Authorized person
| Name | WILLIAM MARK GARNEY |
| Role | PRESIDENT |
| Phone | 8506385512 |
Taxonomy
| Taxonomy Code | 261Q00000X - Clinic/Center |
| Is Primary | Yes |
| Taxonomy Code | 261QR1300X - Rural Health Clinic/Center |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 660167700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| GARNEY WILLIAM M | President | 1765 GAINER ROAD, CHIPLEY, FL, 32428 |
| GARNEY AUDREY J | Secretary | 1765 Gainer Road, CHIPLEY, FL, 32428 |
| GARNEY AUDREY J | Treasurer | 1765 Gainer Road, CHIPLEY, FL, 32428 |
| PORTER ANNETTE G | Vice President | 3025 Clayton Road, Bonifay, FL, 32435 |
| GARNEY WILLIAM M | Agent | 877 3rd Street, CHIPLEY, FL, 32428 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2014-03-11 | 877 3rd Street, SUITE 4, CHIPLEY, FL 32428 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2014-03-11 | 877 3rd Street, SUITE 4, CHIPLEY, FL 32428 | - |
| CANCEL ADM DISS/REV | 2006-04-24 | - | - |
| CHANGE OF MAILING ADDRESS | 2006-04-24 | 877 3rd Street, SUITE 4, CHIPLEY, FL 32428 | - |
| REGISTERED AGENT NAME CHANGED | 2006-04-24 | GARNEY, WILLIAM M | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-19 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-28 |
| ANNUAL REPORT | 2024-01-26 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-03-14 |
| ANNUAL REPORT | 2021-01-26 |
| ANNUAL REPORT | 2020-02-11 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-01-17 |
| ANNUAL REPORT | 2017-01-23 |
| ANNUAL REPORT | 2016-03-11 |
| Inspection Nr | Report ID | Date Opened | Site Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 336627989 | 0419700 | 2012-10-01 | 1376 BRICKYARD ROAD SUITE 5, CHIPLEY, FL, 32428 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Citation ID | 01001A |
| Citaton Type | Serious |
| Standard Cited | 19101030 C01 IV |
| Issuance Date | 2012-11-28 |
| Abatement Due Date | 2012-12-24 |
| Current Penalty | 1020.0 |
| Initial Penalty | 1700.0 |
| Final Order | 2012-12-13 |
| Nr Instances | 1 |
| Nr Exposed | 9 |
| Gravity | 5 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1030(c)(1)(iv): The Exposure Control Plan was not reviewed and updated at least annually: a. On or about October 1, 2012, the employer did not conduct an annual review of the Exposure Control Plan. |
| Citation ID | 01001B |
| Citaton Type | Serious |
| Standard Cited | 19101030 C01 V |
| Issuance Date | 2012-11-28 |
| Abatement Due Date | 2012-12-24 |
| Current Penalty | 0.0 |
| Initial Penalty | 0.0 |
| Final Order | 2012-12-13 |
| Nr Instances | 1 |
| Nr Exposed | 2 |
| Gravity | 5 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1030(c)(1)(v): The employer, who is required to establish an Exposure Control Plan, did not solicit input from non-managerial employees responsible for direct patient care who are potentially exposed to injuries from contaminated sharps in the identification, evaluation and selection of effective engineering and work practice controls and did not document the solicitation in the Exposure Control plan: a. On or about October 1, 2012, the employer did not solicit input from employees who were potentially exposed to injuries from contaminated sharps on the identification, evaluation, and selection of effective engineering controls. |
| Citation ID | 01002 |
| Citaton Type | Serious |
| Standard Cited | 19101030 D02 I |
| Issuance Date | 2012-11-28 |
| Abatement Due Date | 2012-12-24 |
| Current Penalty | 1020.0 |
| Initial Penalty | 1700.0 |
| Final Order | 2012-12-13 |
| Nr Instances | 1 |
| Nr Exposed | 2 |
| Gravity | 5 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1030(d)(2)(i): Engineering and work practice controls were not used to eliminate or minimize employees exposure: a. On or about October 1, 2012, engineering controls such as, but not limited to, needles with engineering protection were not used to guard against employee exposure to needles potentially contaminated with bloodborne pathogens when giving injections. |
| Citation ID | 02001A |
| Citaton Type | Other |
| Standard Cited | 19101200 E01 I |
| Issuance Date | 2012-11-28 |
| Abatement Due Date | 2012-12-24 |
| Current Penalty | 0.0 |
| Initial Penalty | 0.0 |
| Final Order | 2012-12-13 |
| Nr Instances | 1 |
| Nr Exposed | 2 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1200(e)(1)(i): The written hazard communication program did not include a list of the hazardous chemicals known to be present, using an identity that was referenced on the appropriate material safety data sheet: a. On or about October 1, 2012, a list of the hazardous chemicals known to be present in the facility was not included in the company's written hazard communication program. |
| Citation ID | 02001B |
| Citaton Type | Other |
| Standard Cited | 19101200 H01 |
| Issuance Date | 2012-11-28 |
| Abatement Due Date | 2012-12-24 |
| Current Penalty | 0.0 |
| Initial Penalty | 0.0 |
| Final Order | 2012-12-13 |
| Nr Instances | 1 |
| Nr Exposed | 2 |
| FTA Current Penalty | 0.0 |
| Citation text line | 29 CFR 1910.1200(h)(1): The employer did not provide employees with effective information and training on hazardous chemicals in their work area at the time of their initial assignment, and whenever a new physical or health hazard the employees had not previously been trained about was introduced into their work area: a. On or about October 1, 2012, the employer did not provide information and training to employees who had exposure to hazardous materials such as but not limited to isopropanol. |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
