| Entity Name: | AMERICAN DIABETIC SUPPLY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 27 Oct 1995 (29 years ago) |
| Date of dissolution: | 27 May 2018 (7 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 27 May 2018 (7 years ago) |
| Document Number: | P95000082732 |
| FEI/EIN Number | 59-3342460 |
| Address: | 533 N Nova Rd, STE 111D, ORMOND BCH, FL 32174 |
| Mail Address: | 533 N Nova Rd, STE 111D, ORMOND BCH, FL 32174 |
| ZIP code: | 32174 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1679560999 | 2005-10-03 | 2017-02-10 | 400 S ATLANTIC AVE, SUITE 108, ORMOND BEACH, FL, 321767146, US | 400 S ATLANTIC AVE, SUITE 108, ORMOND BEACH, FL, 321767146, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 386-677-1002 |
| Fax | 3866739421 |
Authorized person
| Name | MR. RANDALL HELLE |
| Role | PRESIDENT |
| Phone | 3866771002 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 132357741 |
| State | AR |
| Issuer | MEDICAID |
| Number | 200166480A |
| State | IN |
| Issuer | MEDICAID |
| Number | 00768974A |
| State | GA |
| Issuer | MEDICAID |
| Number | 1689645 |
| State | LA |
| Issuer | MEDICAID |
| Number | 183900000 |
| State | ME |
| Issuer | MEDICAID |
| Number | 100297590A |
| State | KS |
| Issuer | MEDICAID |
| Number | 74200500 |
| State | MD |
| Issuer | MEDICAID |
| Number | 000S7538 |
| State | NM |
| Issuer | MEDICAID |
| Number | 804289900 |
| State | ID |
| Issuer | MEDICAID |
| Number | 010477001 |
| State | TX |
| Issuer | MEDICAID |
| Number | 009705310 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| HELLE, RANDALL | Agent | 533 N Nova Rd suite 111D, ORMOND BEACH, FL 32174 |
| Name | Role | Address |
|---|---|---|
| HELLE, RANDALL | Director | 533 N Nova Rd, Suite 111D ORMOND BEACH, FL 32174 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000094138 | AMERICAN MED DIRECT | EXPIRED | 2010-10-14 | 2015-12-31 | No data | 400 SOUTH ATLANTIC AVENUE., SUITE 108, ORMOND BEACH, FL, 32176 |
| G10000091505 | AMERICAN MEDICAL DIRECT | EXPIRED | 2010-10-06 | 2015-12-31 | No data | 400 SOUTH ATLANTIC AVENUE, SUITE 108, ORMOND BEACH, FL, 32176 |
| G10000091504 | SIGNATURE HOME MEDICAL | EXPIRED | 2010-10-06 | 2015-12-31 | No data | 400 SOUTH ATLANTIC AVENUE, SUITE 108, ORMOND BEACH, FL, 32176 |
| G09000143018 | AMERICAN MEDCARE SUPPLY | EXPIRED | 2009-08-06 | 2014-12-31 | No data | 400 SOUTH ATLANTIC AVE, STE 108, ORMOND BEACH, FL, 32176 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2018-05-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-02-09 | 533 N Nova Rd, STE 111D, ORMOND BCH, FL 32174 | No data |
| CHANGE OF MAILING ADDRESS | 2017-02-09 | 533 N Nova Rd, STE 111D, ORMOND BCH, FL 32174 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-02-09 | 533 N Nova Rd suite 111D, ORMOND BEACH, FL 32174 | No data |
| REGISTERED AGENT NAME CHANGED | 2012-09-28 | HELLE, RANDALL | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-02-09 |
| ANNUAL REPORT | 2016-05-13 |
| ANNUAL REPORT | 2015-04-29 |
| ANNUAL REPORT | 2014-04-24 |
| ANNUAL REPORT | 2013-03-03 |
| Off/Dir Resignation | 2012-10-05 |
| Reg. Agent Change | 2012-09-28 |
| ANNUAL REPORT | 2012-01-04 |
| ANNUAL REPORT | 2011-01-24 |
| ANNUAL REPORT | 2010-01-04 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
