| Entity Name: | PEGASUS AIRWAVE INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Profit |
| Status: | Inactive |
| Date Filed: | 17 Oct 1988 (36 years ago) |
| Branch of: | PEGASUS AIRWAVE INC., ILLINOIS (Company Number CORP_55226989) |
| Document Number: | P21323 |
| FEI/EIN Number | 363606414 |
| Address: | 1180 SW 36 AVE, RM 103, POMPANO BEACH, FL, 33069, US |
| Mail Address: | 2349 W. LAKE STREET, SUITE 250, ADDISON, IL, 60101, US |
| ZIP code: | 33069 |
| County: | Broward |
| Place of Formation: | ILLINOIS |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1710934757 | 2006-05-27 | 2008-11-05 | 1180 S.W. 36TH AVE., SUITE 103, POMPANO BEACH, FL, 33069, US | 1180 S.W. 36TH AVE., SUITE 103, POMPANO BEACH, FL, 33069, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 954-975-6808 |
| Fax | 9542524210 |
Authorized person
| Name | MRS. LORRIE A FRENCH |
| Role | DIRECTOR OF OPERATIONS |
| Phone | 9549756808 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | 1277 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 011388801 |
| State | TX |
| Issuer | MEDICAID |
| Number | 0897785 |
| State | OH |
| Issuer | MEDICAID |
| Number | 9038381 |
| State | WA |
| Issuer | MEDICAID |
| Number | DM0190 |
| State | SC |
| Issuer | MEDICAID |
| Number | 01169240 |
| State | NY |
| Issuer | MEDICAID |
| Number | 100473190A |
| State | IN |
| Issuer | MEDICAID |
| Number | 1532162 |
| State | MA |
| Issuer | MEDICAID |
| Number | 193026100 |
| State | MD |
| Issuer | MEDICAID |
| Number | 9607650 |
| State | AL |
| Issuer | MEDICAID |
| Number | 18340001 |
| State | AZ |
| Issuer | MEDICAID |
| Number | 2874553 |
| State | MI |
| Issuer | MEDICAID |
| Number | DME01951F |
| State | CA |
| Issuer | MEDICAID |
| Number | 004144325 |
| State | CT |
| Issuer | MEDICAID |
| Number | 08002180 |
| State | CO |
| Issuer | MEDICAID |
| Number | 25167400 |
| State | FL |
| Issuer | MEDICAID |
| Number | 00528668A |
| State | GA |
| Issuer | MEDICAID |
| Number | 9108122 |
| State | VA |
| Issuer | MEDICAID |
| Number | 9100192 |
| State | WV |
| Name | Role | Address |
|---|---|---|
| CROXFORD PHIL | President | 2349 W LAKE ST STE 250, ADDISON, IL, 60101 |
| Name | Role | Address |
|---|---|---|
| WESNER DAVID | Secretary | 2349 W. LAKE STREET, ADDISON, IL, 60101 |
| Name | Role | Address |
|---|---|---|
| JENSEN GARY | Treasurer | 2349 W. LAKE STREET, ADDISION, IL, 60101 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| WITHDRAWAL | 2012-01-30 | No data | No data |
| CANCEL ADM DISS/REV | 2010-02-08 | No data | No data |
| REVOKED FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| REINSTATEMENT | 2006-05-30 | No data | No data |
| REVOKED FOR ANNUAL REPORT | 2005-09-16 | No data | No data |
| CANCEL ADM DISS/REV | 2004-10-22 | No data | No data |
| REVOKED FOR ANNUAL REPORT | 2004-10-01 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J06000258314 | TERMINATED | 1000000035831 | 20999 00143 | 2006-10-24 | 2011-11-08 | $ 13,395.75 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE/CENTRAL COLLECTIONS UNIT, 1379 BLOUNTSTOWN HWY, TALLAHASSEE FL323042716 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
