| Entity Name: | TRI-COUNTY AUDIOLOGY AND HEARING AID SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 13 Jun 1996 (29 years ago) |
| Document Number: | P96000051084 |
| FEI/EIN Number | 593386113 |
| Mail Address: | 2314 S. Gabin Terrace, Homosassa, FL, 34448, US |
| Address: | 3519 N LECANTO HWY, BEVERLY HILLS, FL, 34465, US |
| ZIP code: | 34465 |
| County: | Citrus |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1982987103 | 2011-09-23 | 2016-02-04 | 3519 N LECANTO HWY, BEVERLY HILLS, FL, 344653501, US | 3519 N LECANTO HWY, BEVERLY HILLS, FL, 344653501, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 352-746-1133 |
| Fax | 3527463474 |
Authorized person
| Name | MRS. REBEKAH PETTY |
| Role | OWNER |
| Phone | 3527461133 |
Taxonomy
| Taxonomy Code | 332S00000X - Hearing Aid Equipment |
| License Number | AS5043 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELDS |
| Number | J0158 |
| State | FL |
| Issuer | AVAILITY |
| Number | 543064 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PETTY REBEKAH W | Agent | 2314 S. Gabin Terrace, Homosassa, FL, 34448 |
| Name | Role | Address |
|---|---|---|
| PETTY JASON | President | 2314 S. Gabin Terrace, Homosassa, FL, 34448 |
| Name | Role | Address |
|---|---|---|
| BROWN MICHAEL R | Secretary | 1248 Wheatley Street, Port Charlotte, FL, 33953 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G19000033079 | EAR TO HEAR HEALTHCARE | ACTIVE | 2019-03-12 | 2029-12-31 | No data | 4117 HWY J, FREDERICKTOWN, MO, 63645 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2015-12-11 | No data | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
