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  5. WEST COAST - SOUTHERN MEDICAL SERVICE, INC.

WEST COAST - SOUTHERN MEDICAL SERVICE, INC.

Company Details

Entity Name: WEST COAST - SOUTHERN MEDICAL SERVICE, INC.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 15 Feb 1994 (31 years ago)
Last Event: AMENDMENT
Event Date Filed: 12 Sep 2022 (2 years ago)
Document Number: P94000012614
FEI/EIN Number 65-0468742
Address: 934 14TH STREET WEST, BRADENTON, FL 34205
Mail Address: 934 14TH STREET WEST, BRADENTON, FL 34205
ZIP code: 34205
County: Manatee
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1740284785 2005-06-08 2012-11-28 934 14TH ST W, BRADENTON, FL, 342056646, US 934 14TH ST W, BRADENTON, FL, 342056646, US

Contacts
Phone +1 941-748-7148
Fax 9417487265
Fax 9417488520

Authorized person
Name MS. CAROLE A. MCGOWAN
Role VICE PRESIDENT
Phone 9417487148

Taxonomy
Taxonomy Code 3416L0300X - Land Ambulance
License Number 002614
State FL
Is Primary Yes

Other Provider Identifiers
Issuer BLACK LUNG PROGRAM
Number 080288100
Issuer MEDICAID
Number 400017005
State FL
Issuer MEDICAID
Number 40001700
State FL
Issuer MEDICAID
Number 400017002
State FL
Issuer MAINE CARE
Number 429840000
Issuer MEDICAID
Number 400017004
State FL
Issuer UNIVERSAL HEALTHCARE
Number 00559
Issuer RAILROAD MEDICARE
Number 590009510
Issuer US DEPT OF LABOR WORK COM
Number 203246400
Issuer MEDICAID
Number 400017003
State FL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
WEST COAST-SOUTHERN MEDICAL SERVICE, INC 401(K) PLAN 2023 650468742 2024-09-05 WEST COAST-SOUTHERN MEDICAL SERVICE, INC. 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-05-02
Business code 621900
Sponsor’s telephone number 9417487148
Plan sponsor’s address 934 14TH STREET WEST, BRADENTON, FL, 342056646
WEST COAST-SOUTHERN MEDICAL SERVICE, INC 401(K) PLAN 2022 650468742 2023-08-25 WEST COAST-SOUTHERN MEDICAL SERVICE, INC. 34
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-05-02
Business code 621900
Sponsor’s telephone number 9417487148
Plan sponsor’s address 934 14TH STREET WEST, BRADENTON, FL, 342056646
WEST COAST-SOUTHERN MEDICAL SERVICE, INC 401(K) PLAN 2021 650468742 2022-09-21 WEST COAST-SOUTHERN MEDICAL SERVICE, INC. 38
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-05-02
Business code 621900
Sponsor’s telephone number 9417487148
Plan sponsor’s address 934 14TH STREET WEST, BRADENTON, FL, 342056646
WEST COAST-SOUTHERN MEDICAL SERVICE, INC 401(K) PLAN 2020 650468742 2021-04-29 WEST COAST-SOUTHERN MEDICAL SERVICE, INC. 42
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-05-02
Business code 621900
Sponsor’s telephone number 9417487148
Plan sponsor’s address 934 14TH STREET WEST, BRADENTON, FL, 342056646
WEST COAST-SOUTHERN MEDICAL SERVICE, INC 401(K) PLAN 2019 650468742 2020-06-23 WEST COAST-SOUTHERN MEDICAL SERVICE, INC. 43
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-05-02
Business code 621900
Sponsor’s telephone number 9417487148
Plan sponsor’s address 934 14TH STREET WEST, BRADENTON, FL, 342056646
WEST COAST-SOUTHERN MEDICAL SERVICE, INC 401(K) PLAN 2018 650468742 2019-06-20 WEST COAST-SOUTHERN MEDICAL SERVICE, INC. 53
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-05-02
Business code 621900
Sponsor’s telephone number 9417487148
Plan sponsor’s address 934 14TH STREET WEST, BRADENTON, FL, 342056646
WEST COAST-SOUTHERN MEDICAL SERVICE, INC 401(K) PLAN 2017 650468742 2018-05-16 WEST COAST-SOUTHERN MEDICAL SERVICE, INC. 55
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-05-02
Business code 621900
Sponsor’s telephone number 9417487148
Plan sponsor’s address 934 14TH STREET WEST, BRADENTON, FL, 342056646
WEST COAST-SOUTHERN MEDICAL SERVICE 401K PLA 2016 650468742 2017-09-25 WEST COAST-SOUTHERN MEDICAL SERVICE, INC. 36
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-05-02
Business code 621900
Sponsor’s telephone number 9417487148
Plan sponsor’s address 934 14TH STREET WEST, BRADENTON, FL, 342056646
WEST COAST-SOUTHERN MEDICAL SERVICE 401K PLA 2015 650468742 2016-05-23 WEST COAST-SOUTHERN MEDICAL SERVICE, INC. 45
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-05-02
Business code 621900
Sponsor’s telephone number 9417487148
Plan sponsor’s address 934 14TH STREET WEST, BRADENTON, FL, 342056646
WEST COAST-SOUTHERN MEDICAL SERVICE 401K PLA 2014 650468742 2015-08-26 WEST COAST-SOUTHERN MEDICAL SERVICE, INC. 51
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2005-05-02
Business code 621900
Sponsor’s telephone number 9417487148
Plan sponsor’s address 934 TAMIAMI TRAIL, BRADENTON, FL, 342056646

Signature of
Role Plan administrator
Date 2015-08-26
Name of individual signing CAROLE MCGOWAN
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
SHANNON, J. RAYMOND Agent 934 14TH STREET WEST, BRADENTON, FL 34205

Director

Name Role Address
SHANNON, J. RAYMOND Director 934 14TH STREET WEST, BRADENTON, FL 34205

President

Name Role Address
SHANNON, J RAYMOND President 934 14 ST W, BRADENTON, FL

Secretary

Name Role Address
SHANNON, J RAYMOND Secretary 934 14 ST W, BRADENTON, FL
SHANNON, JUDITH Secretary 934 14TH STREET WEST, BRADENTON, FL 34205

Vice President

Name Role Address
McFarren, Mathew Vice President 934 14TH STREET WEST, BRADENTON, FL 34205

Treasurer

Name Role Address
SHANNON, JOSEPH R Treasurer 934 14TH STREET WEST, BRADENTON, FL 34205

Events

Event Type Filed Date Value Description
AMENDMENT 2022-09-12 No data No data
AMENDMENT 2010-01-14 No data No data
CHANGE OF PRINCIPAL ADDRESS 1996-01-23 934 14TH STREET WEST, BRADENTON, FL 34205 No data
CHANGE OF MAILING ADDRESS 1996-01-23 934 14TH STREET WEST, BRADENTON, FL 34205 No data
REGISTERED AGENT ADDRESS CHANGED 1996-01-23 934 14TH STREET WEST, BRADENTON, FL 34205 No data

Documents

Name Date
ANNUAL REPORT 2025-01-13
AMENDED ANNUAL REPORT 2024-01-13
ANNUAL REPORT 2024-01-03
ANNUAL REPORT 2023-01-04
Amendment 2022-09-12
ANNUAL REPORT 2022-01-03
ANNUAL REPORT 2021-01-04
ANNUAL REPORT 2020-01-06
ANNUAL REPORT 2019-01-10
ANNUAL REPORT 2018-01-10

Related by officers

SHANNON, J RAYMOND

GULF COAST MEDICAL TRANSPORT SERVICE, INC.

SHANNON, JOSEPH R

WEST COAST MEDICAL TRANSFER SERVICE, INC.

Related by address

934 14TH STREET WEST, BRADENTON, FL 34205

GULF COAST MEDICAL TRANSPORT SERVICE, INC. AMBCO & ASSOCIATES, INC. WEST COAST MEDICAL TRANSFER SERVICE, INC. SOUTHERN MEDICAL SERVICES CORPORATION MASTER TECH. MACHINE, INC.

934 14TH STREET WEST, BRADENTON, FL 34205

GULF COAST MEDICAL TRANSPORT SERVICE, INC. AMBCO & ASSOCIATES, INC. WEST COAST MEDICAL TRANSFER SERVICE, INC. SOUTHERN MEDICAL SERVICES CORPORATION MASTER TECH. MACHINE, INC.

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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