| Entity Name: | CORAM HEALTHCARE CORPORATION OF SOUTHERN FLORIDA |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Profit Corporation |
| Status: | Active |
| Date Filed: | 09 Sep 1991 (33 years ago) |
| Last Event: | NAME CHANGE AMENDMENT |
| Event Date Filed: | 17 Jan 1995 (30 years ago) |
| Document Number: | P35437 |
| FEI/EIN Number | 58-1949686 |
| Address: | One CVS Drive, Woonsocket, RI 02895 |
| Mail Address: | One CVS Drive, Woonsocket, RI 02895 |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053365544 | 2006-05-20 | 2023-03-07 | PO BOX 809160, CHICAGO, IL, 606809160, US | 261 N UNIVERSITY DR, PLANTATION, FL, 333242002, US | |||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 480-765-5043 |
| Fax | 4017330211 |
| Phone | +1 954-829-4490 |
Authorized person
| Name | TRICIA LACAVICH |
| Role | PRESADENT |
| Phone | 3143063255 |
Taxonomy
| Taxonomy Code | 251E00000X - Home Health Agency |
| Is Primary | No |
| Taxonomy Code | 251F00000X - Home Infusion Agency |
| License Number | HHA20290096 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336H0001X - Home Infusion Therapy Pharmacy |
| License Number | PH23578 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | PHARMACY PERMIT |
| Number | PH23578 |
| State | FL |
| Issuer | HOME HEALTH AGENCY |
| Number | HHA20290096 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 |
| Name | Role | Address |
|---|---|---|
| Moffatt, Thomas S. | Vice President | One CVS Drive, Woonsocket, RI 02895 |
| Name | Role | Address |
|---|---|---|
| Moffatt, Thomas S. | Secretary | One CVS Drive, Woonsocket, RI 02895 |
| Name | Role | Address |
|---|---|---|
| St Angelo, Melanie K. | Assistant Secretary | One CVS Drive, Woonsocket, RI 02895 |
| DeSousa, Kimberley M. | Assistant Secretary | One CVS Drive, Woonsocket, RI 02895 |
| Dehner, Kevin M. | Assistant Secretary | One CVS Drive, Woonsocket, RI 02895 |
| Smith, Joshua J. | Assistant Secretary | One CVS Drive, Woonsocket, RI 02895 |
| Name | Role | Address |
|---|---|---|
| Beaulieu, Sheelagh M. | Assistant Treasurer | One CVS Drive, Woonsocket, RI 02895 |
| Cole, Joshua C. | Assistant Treasurer | One CVS Drive, Woonsocket, RI 02895 |
| Name | Role | Address |
|---|---|---|
| Moffatt, Thomas S. | Director | One CVS Drive, Woonsocket, RI 02895 |
| Weinert, Craig S. | Director | One CVS Drive, Woonsocket, RI 02895 |
| Name | Role | Address |
|---|---|---|
| Weinert, Craig S. | President | One CVS Drive, Woonsocket, RI 02895 |
| Name | Role | Address |
|---|---|---|
| Weinert, Craig S. | Treasurer | One CVS Drive, Woonsocket, RI 02895 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000057758 | CORAM CVS/SPECIALTY INFUSION SERVICES #48095 | ACTIVE | 2017-05-24 | 2027-12-31 | No data | 12006 MIRAMAR PARKWAY, MIRAMAR, FL, 33025 |
| G14000016568 | CORAM SPECIALITY INFUSION SERVICES,A CVS CAREMARK COMPANY | EXPIRED | 2014-02-17 | 2019-12-31 | No data | 555 17TH STREET,SUITE 1500, DENVER, CO, 80202 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-01 | One CVS Drive, Woonsocket, RI 02895 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-01 | One CVS Drive, Woonsocket, RI 02895 | No data |
| REGISTERED AGENT NAME CHANGED | 2016-10-24 | CT CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-10-24 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| NAME CHANGE AMENDMENT | 1995-01-17 | CORAM HEALTHCARE CORPORATION OF SOUTHERN FLORIDA | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-01 |
| ANNUAL REPORT | 2023-03-03 |
| ANNUAL REPORT | 2022-04-20 |
| ANNUAL REPORT | 2021-04-27 |
| ANNUAL REPORT | 2020-04-20 |
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-04-24 |
| ANNUAL REPORT | 2017-04-28 |
| Reg. Agent Change | 2016-10-24 |
| ANNUAL REPORT | 2016-01-07 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
