| Entity Name: | INTEGRA MEDICAL SUPPLY INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 25 Jan 2019 (6 years ago) |
| Document Number: | P19000007139 |
| FEI/EIN Number | 83-3305622 |
| Address: | 399 CAMINO GARDENS BLVD,, SUITE #102, BOCA RATON, FL 33432 |
| Mail Address: | 399 CAMINO GARDENS BLVD,, SUITE #102, BOCA RATON, FL 33432 |
| ZIP code: | 33432 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | INTEGRA MEDICAL SUPPLY INC., CONNECTICUT | 3125589 | CONNECTICUT |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760947592 | 2019-02-06 | 2021-09-20 | 800 SE 20TH AVE APT 1111, DEERFIELD BEACH, FL, 334415195, US | 399 CAMINO GARDENS BLVD STE 102, BOCA RATON, FL, 334325828, US | |||||||||||||||||||
|
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| Phone | +1 561-440-8550 |
Authorized person
| Name | MRS. MEGHANA B PATEL |
| Role | CEO |
| Phone | 5614408550 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 109794900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PATEL, MEGHANA | Agent | 800 SE 20 AVE, 1111, DEERFIELD BEACH, FL 33441 |
| Name | Role | Address |
|---|---|---|
| PATEL, MEGHANA | Chief Executive Officer | 800 SE 20 AVE # 1111, DEER FIELD BEACH, FL 33441 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2019-02-13 | 399 CAMINO GARDENS BLVD,, SUITE #102, BOCA RATON, FL 33432 | No data |
| CHANGE OF MAILING ADDRESS | 2019-02-13 | 399 CAMINO GARDENS BLVD,, SUITE #102, BOCA RATON, FL 33432 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-31 |
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-02-13 |
| ANNUAL REPORT | 2022-01-30 |
| ANNUAL REPORT | 2021-07-27 |
| ANNUAL REPORT | 2020-02-22 |
| Domestic Profit | 2019-01-25 |
Date of last update: 16 Feb 2025
Sources: Florida Department of State
