| Entity Name: | OPTUM INFUSION SERVICES 205, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 18 Nov 2008 (16 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 15 Sep 2020 (4 years ago) |
| Document Number: | P08000102522 |
| FEI/EIN Number | 26-3738273 |
| Address: | 15529 College Blvd., Lenexa, KS, 66219-1351, US |
| Mail Address: | 15529 College Blvd., Lenexa, KS, 66219-1351, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790009256 | 2010-03-26 | 2020-01-06 | 15529 COLLEGE BLVD, LENEXA, KS, 662191351, US | 1812 RIGGINS RD, SUITE 2, TALLAHASSEE, FL, 323087833, US | |||||||||||||||||||||||||
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| Phone | +1 877-342-9352 |
| Fax | 8775429352 |
| Phone | +1 954-796-3338 |
| Fax | 9547963402 |
Authorized person
| Name | KIMBERLEY WILLIAMS |
| Role | COMPLIANCE ANALYST |
| Phone | 9133356786 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | HOME HEALTH AGENCY LICENSE |
| Number | 299993694 |
| State | FL |
| Name | Role |
|---|---|
| C T CORPORATION SYSTEM | Agent |
| Name | Role | Address |
|---|---|---|
| Bohmer Karen E | Secretary | 15529 College Blvd., Lenexa, KS, 662191351 |
| Name | Role | Address |
|---|---|---|
| Lang Heather A | Assi | 15529 College Blvd., Lenexa, KS, 662191351 |
| Name | Role | Address |
|---|---|---|
| Carey Kathryn E | Director | 15529 College Blvd., Lenexa, KS, 662191351 |
| Name | Role | Address |
|---|---|---|
| Satterwhite Erin A | Chief Executive Officer | 15529 College Blvd., Lenexa, KS, 662191351 |
| Name | Role |
|---|---|
| AMBIENT HEALTHCARE, INC. | Owne |
| Name | Role | Address |
|---|---|---|
| Hirsch Marilyn E | Treasurer | 15529 College Blvd., Lenexa, KS, 662191351 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2020-09-15 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-05-19 | 15529 College Blvd., Lenexa, KS 66219-1351 | No data |
| CHANGE OF MAILING ADDRESS | 2020-05-19 | 15529 College Blvd., Lenexa, KS 66219-1351 | No data |
| NAME CHANGE AMENDMENT | 2019-08-28 | OPTUM INFUSION SERVICES 205, INC. | No data |
| AMENDMENT AND NAME CHANGE | 2017-08-17 | BRIOVARX INFUSION SERVICES 205, INC. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-05-16 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| REGISTERED AGENT NAME CHANGED | 2016-05-16 | C T CORPORATION SYSTEM | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-10-01 |
| AMENDED ANNUAL REPORT | 2024-07-01 |
| AMENDED ANNUAL REPORT | 2024-06-28 |
| ANNUAL REPORT | 2024-04-20 |
| ANNUAL REPORT | 2023-04-21 |
| ANNUAL REPORT | 2022-04-20 |
| ANNUAL REPORT | 2021-04-24 |
| Amendment | 2020-09-15 |
| AMENDED ANNUAL REPORT | 2020-08-25 |
| ANNUAL REPORT | 2020-05-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
