| Entity Name: | HEALTHMARK OF WALTON RURAL HEALTH CLINIC, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
HEALTHMARK OF WALTON RURAL HEALTH CLINIC, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 18 Dec 1992 (32 years ago) |
| Date of dissolution: | 22 Sep 2023 (a year ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2023 (a year ago) |
| Document Number: | P92000012940 |
| FEI/EIN Number |
593156240
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 4415 HWY 331 SOUTH, DEFUNIAK SPRINGS, FL, 32435, US |
| Mail Address: | 4415 HWY 331 SOUTH, DEFUNIAK SPRINGS, FL, 32435, US |
| ZIP code: | 32435 |
| County: | Walton |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1013908201 | 2005-11-04 | 2021-09-27 | 4415 US HIGHWAY 331 S, DEFUNIAK SPRINGS, FL, 324356307, US | 4415 US HIGHWAY 331 S, DEFUNIAK SPRINGS, FL, 324356307, US | |||||||||||||||||||||
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| Phone | +1 850-951-4640 |
| Fax | 8508927079 |
Authorized person
| Name | MS. LISA SHIRLEY HOLLEY |
| Role | COO |
| Phone | 8509514507 |
Taxonomy
| Taxonomy Code | 261QR1300X - Rural Health Clinic/Center |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 372384401 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| THOMPSON JAMES H | Director | 4413 HWY 331 SOUTH, DEFUNIAK SPRINGS, FL, 32435 |
| Holley Lisa | Director | 4413 HWY 331 SOUTH, DEFUNIAK SPRINGS, FL, 32435 |
| Jenkins Terri L | Director | 4413 US Hwy 331 South, DeFuniak Springs, FL, 32435 |
| THOMPSON JAMES HPhd | Agent | 4413 HWY 331- SOUTH, DEFUNIAK SPRINGS, FL, 32435 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G22000086531 | 331 MEDICAL CENTER | ACTIVE | 2022-07-21 | 2027-12-31 | - | 4415 HWY 331 SOUTH, DEFUNIAK SPRINGS, FL, 32435 |
| G12000069726 | HEALTHMARK CLINIC | ACTIVE | 2012-07-12 | 2027-12-31 | - | 4415 HWY 331 SOUTH, DEFUNIAK SPRINGS, FL, 32435 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | - | - |
| REGISTERED AGENT NAME CHANGED | 2013-03-26 | THOMPSON, JAMES H, Phd | - |
| CHANGE OF PRINCIPAL ADDRESS | 2007-04-02 | 4415 HWY 331 SOUTH, DEFUNIAK SPRINGS, FL 32435 | - |
| CHANGE OF MAILING ADDRESS | 2007-04-02 | 4415 HWY 331 SOUTH, DEFUNIAK SPRINGS, FL 32435 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2001-04-19 | 4413 HWY 331- SOUTH, DEFUNIAK SPRINGS, FL 32435 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2022-02-23 |
| ANNUAL REPORT | 2021-07-29 |
| ANNUAL REPORT | 2020-02-05 |
| ANNUAL REPORT | 2019-05-15 |
| ANNUAL REPORT | 2018-03-28 |
| ANNUAL REPORT | 2017-04-06 |
| ANNUAL REPORT | 2016-01-22 |
| ANNUAL REPORT | 2015-03-23 |
| ANNUAL REPORT | 2014-03-03 |
| ANNUAL REPORT | 2013-03-26 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2090077300 | 2020-04-29 | 0491 | PPP | 4415 US Hwy 331 S, DEFUNIAK SPRINGS, FL, 32435-6307 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Mar 2025
Sources: Florida Department of State
