| Entity Name: | TUPELO PRIMARY CARE, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 22 Mar 2022 (3 years ago) |
| Document Number: | P22000025617 |
| FEI/EIN Number | 88-0849808 |
| Address: | 412 North Hwy 71, WEWAHITCHKA, FL 32465 |
| Mail Address: | 412 North Hwy 71, Wewahitchka, FL 32465 |
| ZIP code: | 32465 |
| County: | Gulf |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649976770 | 2023-01-31 | 2023-08-25 | 412 N HIGHWAY 71, WEWAHITCHKA, FL, 324654061, US | 412 N HIGHWAY 71, WEWAHITCHKA, FL, 324654061, US | |||||||||||||
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| Phone | +1 850-227-8561 |
Authorized person
| Name | AMY MILLER |
| Role | OWNER |
| Phone | 8502278561 |
Taxonomy
| Taxonomy Code | 363LP2300X - Primary Care Nurse Practitioner |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MILLER, AMY L | Agent | 265 GARY ROWELL ROAD, WEWAHITCHKA, FL 32465 |
| Name | Role | Address |
|---|---|---|
| MILLER, AMY L | President | 265 Gary Rowell Road, WEWAHITCHKA, FL 32465 |
| Name | Role | Address |
|---|---|---|
| MILLER, JASON S | Vice President | 265 GARY ROWELL ROAD, WEWAHITCHKA, FL 32465 |
| Name | Role | Address |
|---|---|---|
| MILLER, AMY L | Chief Financial Officer | 265 Gary Rowell Road, WEWAHITCHKA, FL 32465 |
| Name | Role | Address |
|---|---|---|
| MILLER, AMY L | Secretary | 265 Gary Rowell Road, WEWAHITCHKA, FL 32465 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2024-02-09 | 412 North Hwy 71, WEWAHITCHKA, FL 32465 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-11-26 | 412 North Hwy 71, WEWAHITCHKA, FL 32465 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-09 |
| AMENDED ANNUAL REPORT | 2023-11-26 |
| ANNUAL REPORT | 2023-03-10 |
| Domestic Profit | 2022-03-22 |
Date of last update: 12 Jan 2025
Sources: Florida Department of State
