| Entity Name: | ADVANCED MOBILITY SOLUTIONS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 07 Oct 2002 (22 years ago) |
| Document Number: | P02000108212 |
| FEI/EIN Number | 331025214 |
| Address: | 465 EAST MAIN STREET, BARTOW, FL, 33830, US |
| Mail Address: | 465 EAST MAIN STREET, BARTOW, FL, 33830, US |
| ZIP code: | 33830 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1932154622 | 2006-05-23 | 2010-02-09 | 465 E MAIN ST, BARTOW, FL, 338304718, US | 465 E MAIN ST, BARTOW, FL, 338304718, US | |||||||||||||||||||||||||||||||||||||||
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| Phone | +1 863-533-3666 |
| Fax | 8635348647 |
Authorized person
| Name | JAMI JENKINS |
| Role | DIRECTOR |
| Phone | 8635333666 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 1896 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 332BC3200X - Customized Equipment (DME) |
| License Number | 1896 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BLUECROSS AND BLUESHIELD |
| Number | R9469 |
| State | FL |
| Issuer | MEDICAID |
| Number | 025776100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LANCASTER JOHN J | Agent | 500 SOUTH FLORIDA AVENUE, LAKELAND, FL, 33801 |
| Name | Role | Address |
|---|---|---|
| JENKINS WILLIAM | President | 465 EAST MAIN STREET, BARTOW, FL, 33830 |
| Name | Role | Address |
|---|---|---|
| JENKINS JAMISON J | Vice President | 465 EAST MAIN STREET, BARTOW, FL, 33830 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| CANCEL ADM DISS/REV | 2007-10-11 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
