| Entity Name: | PALMER MEDICAL SUPPLIES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 07 Jan 1998 (27 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | P98000002442 |
| FEI/EIN Number | 59-3489813 |
| Address: | 2686 Chapman Drive, PANAMA CITY, FL 32405 |
| Mail Address: | P.O. Box 15326, PANAMA CITY, FL 32406 |
| ZIP code: | 32405 |
| County: | Bay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457432338 | 2006-10-18 | 2014-01-13 | 2686 CHAPMAN DRIVE, PANAMA CITY, FL, 32405, US | 2686 CHAPMAN DRIVE, PANAMA CITY, FL, 32405, US | |||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 850-784-0070 |
| Fax | 8507842800 |
Authorized person
| Name | MRS. TAMARA A. LILLARD |
| Role | OWNER/MANAGER |
| Phone | 8507840070 |
Taxonomy
| Taxonomy Code | 224900000X - Mastectomy Fitter |
| Is Primary | No |
| Taxonomy Code | 225000000X - Orthotic Fitter |
| Is Primary | No |
| Taxonomy Code | 227900000X - Registered Respiratory Therapist |
| Is Primary | No |
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | Yes |
| Taxonomy Code | 332BX2000X - Oxygen Equipment & Supplies (DME) |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BLUE CROSS BLUE SHIELD OF |
| Number | R8213 |
| State | FL |
| Issuer | MEDICAID |
| Number | 022583500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| LAPEER, RUSSELL W | Agent | 445 N.E. 8TH AVENUE, OCALA, FL 34470 |
| Name | Role | Address |
|---|---|---|
| LILLARD, TAMARA A | President | 2686 Chapman Drive, PANAMA CITY, FL 32405 |
| Name | Role | Address |
|---|---|---|
| ROWE, JENNIFER L | Manager | 2686 Chapman Drive, PANAMA CITY, FL 32405 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-12-16 | 2686 Chapman Drive, PANAMA CITY, FL 32405 | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-25 | 2686 Chapman Drive, PANAMA CITY, FL 32405 | No data |
| REINSTATEMENT | 2003-10-17 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2003-09-19 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13000790718 | ACTIVE | 1000000382890 | BROWARD | 2013-04-15 | 2033-04-24 | $ 660.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3301 N UNIVERSITY DR STE 200, CORAL SPRINGS FL330654149 |
| J13000369109 | ACTIVE | 1000000382826 | PALM BEACH | 2012-12-12 | 2033-02-13 | $ 839.64 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, OUT OF STATE COLLECTIONS UNIT, 1401 W US HIGHWAY 90 STE 100, LAKE CITY FL320556123 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2015-04-26 |
| ANNUAL REPORT | 2014-03-28 |
| AMENDED ANNUAL REPORT | 2013-12-16 |
| ANNUAL REPORT | 2013-04-25 |
| ANNUAL REPORT | 2012-02-17 |
| ANNUAL REPORT | 2011-01-31 |
| ANNUAL REPORT | 2010-08-09 |
| ANNUAL REPORT | 2009-04-29 |
| ANNUAL REPORT | 2008-08-08 |
| ANNUAL REPORT | 2007-04-27 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
