| Entity Name: | HOMETOWN MEDICAL SUPPLY INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 27 Mar 2003 (22 years ago) |
| Date of dissolution: | 25 Sep 2009 (15 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2009 (15 years ago) |
| Document Number: | P03000035236 |
| FEI/EIN Number | 050572579 |
| Address: | 516 JOEL BLVD, UNIT D, LEHIGH ACRES, FL, 33936 |
| Mail Address: | 516 JOEL BLVD, UNIT D, LEHIGH ACRES, FL, 33972 |
| ZIP code: | 33936 |
| County: | Lee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1225007685 | 2006-03-16 | 2008-11-04 | 516 JOEL BLVD, UNIT D, LEHIGH ACRES, FL, 339364305, US | 516 JOEL BLVD, UNIT D, LEHIGH ACRES, FL, 339364305, US | |||||||||||||||||||||||
|
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| Phone | +1 239-369-1425 |
| Fax | 2393695927 |
Authorized person
| Name | MISS JESICA SANTANA COLON |
| Role | PRESIDENT |
| Phone | 2393691425 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 026226900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SANTANA COLON JESICA | Agent | 1650 WERNER DRIVE, ALVA, FL, 33920 |
| Name | Role | Address |
|---|---|---|
| SANTANA COLON JESICA | Director | 1650 WERNER DRIVE, ALVA, FL, 33920 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-06-19 | 516 JOEL BLVD, UNIT D, LEHIGH ACRES, FL 33936 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-06-19 | 1650 WERNER DRIVE, ALVA, FL 33920 | No data |
| REGISTERED AGENT NAME CHANGED | 2007-02-21 | SANTANA COLON, JESICA | No data |
| CHANGE OF MAILING ADDRESS | 2006-04-28 | 516 JOEL BLVD, UNIT D, LEHIGH ACRES, FL 33936 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J11000404843 | ACTIVE | 1000000219329 | LEE | 2011-06-15 | 2031-06-29 | $ 498.86 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE/CENTRAL COLLECTIONS UNIT, 5050 W TENNESSEE ST, TALLAHASSEE FL323996586 |
| J11000417803 | LAPSED | 1000000219330 | LEE | 2011-06-15 | 2021-07-06 | $ 2,063.70 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE/CENTRAL COLLECTIONS UNIT, 5050 W TENNESSEE ST, TALLAHASSEE FL323996586 |
| J10000086071 | ACTIVE | 1000000093808 | LEE | 2008-09-30 | 2030-02-15 | $ 931.28 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE/CENTRAL COLLECTIONS UNIT, 5050 W TENNESSEE ST, TALLAHASSEE FL323996586 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2008-06-19 |
| ANNUAL REPORT | 2007-02-21 |
| ANNUAL REPORT | 2006-04-28 |
| ANNUAL REPORT | 2005-04-29 |
| ANNUAL REPORT | 2004-06-28 |
| Domestic Profit | 2003-03-28 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
