| Entity Name: | EMORY MEDICAL CORPORATION |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 06 Apr 2010 (15 years ago) |
| Document Number: | P10000029859 |
| FEI/EIN Number | 272312616 |
| Address: | 4812 W US Hwy 90,, LAKE CITY, FL, 32055, US |
| Mail Address: | EMORY MEDICAL CORPORATION, P.O.BOX 1646, LAKE CITY, FL, 32056 |
| ZIP code: | 32055 |
| County: | Columbia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033542485 | 2013-08-20 | 2013-08-22 | PO BOX 1646, LAKE CITY, FL, 320561646, US | 1546 S WATER ST, STE. A, STARKE, FL, 320914511, US | |||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||
| Phone | +1 904-964-4777 |
| Fax | 9049644780 |
Authorized person
| Name | MRS. AMANDA BOLT |
| Role | OFFICE MANAGER |
| Phone | 3864661106 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | 2093 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 261QP2300X - Primary Care Clinic/Center |
| Is Primary | No |
| Taxonomy Code | 261QR1300X - Rural Health Clinic/Center |
| Is Primary | No |
| Name | Role | Address |
|---|---|---|
| MOHAN CHANDLER VDr. | Agent | EMORY MEDICAL CORPORATION, LAKE CITY, FL, 32055 |
| Name | Role | Address |
|---|---|---|
| MOHAN CHANDLER VDr. | President | 4812 W USHwy 90, LAKE CITY, FL, 32055 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000086014 | WOMEN'S CENTER OF FLORIDA | ACTIVE | 2010-09-21 | 2025-12-31 | No data | P O BOX 1646, LAKE CITY, FL, 32056 |
| G10000075895 | WOMENS CENTER AT SHANDS | EXPIRED | 2010-08-18 | 2015-12-31 | No data | 351 NE FRANKLIN STREET, #125, LAKE CITY, FL, 32055 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2015-03-16 | 4812 W US Hwy 90,, Suite # A, LAKE CITY, FL 32055 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-03-16 | EMORY MEDICAL CORPORATION, 4812 W US Hwy 90, Suite # A, LAKE CITY, FL 32055 | No data |
| REGISTERED AGENT NAME CHANGED | 2013-03-28 | MOHAN, CHANDLER V, Dr. | No data |
| CHANGE OF MAILING ADDRESS | 2011-04-21 | 4812 W US Hwy 90,, Suite # A, LAKE CITY, FL 32055 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2023-03-06 |
| ANNUAL REPORT | 2022-02-01 |
| ANNUAL REPORT | 2021-02-08 |
| AMENDED ANNUAL REPORT | 2020-01-31 |
| ANNUAL REPORT | 2020-01-02 |
| ANNUAL REPORT | 2019-03-04 |
| ANNUAL REPORT | 2018-02-05 |
| ANNUAL REPORT | 2017-01-26 |
| ANNUAL REPORT | 2016-03-22 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
