| Entity Name: | CUSTOM MEDICAL SYSTEMS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 16 Jul 1991 (34 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 23 Oct 2017 (7 years ago) |
| Document Number: | S68702 |
| FEI/EIN Number | 65-0273613 |
| Address: | 404 10th Ave W, Palmetto, FL 34221 |
| Mail Address: | 404 10TH AVE. W, PALMETTO, FL 34221 |
| ZIP code: | 34221 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710162912 | 2008-01-07 | 2008-01-15 | 404 10TH AVE W, PALMETTO, FL, 342215032, US | 404 10TH AVE W, PALMETTO, FL, 342215032, US | |||||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 941-722-3434 |
Authorized person
| Name | ALAN A. LOVESKY |
| Role | OWNER/MGR |
| Phone | 9417223434 |
Taxonomy
| Taxonomy Code | 332BC3200X - Customized Equipment (DME) |
| License Number | 542 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | HOME & COMM. BASE WAIVER |
| Number | 671444798 |
| State | FL |
| Issuer | BRAIN & SPINAL WAIVER |
| Number | 686838079 |
| State | FL |
| Issuer | DEVELOPMT DISAB WAIVER |
| Number | 671444796 |
| State | FL |
| Issuer | AGE & DIS PERSON WAIVER |
| Number | 686628000 |
| State | FL |
| Issuer | MEDICAID |
| Number | 028786500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Lovesky, Alan A | Agent | 2450 Desoto Rd, Sarasota, FL 34234 |
| Name | Role | Address |
|---|---|---|
| LOVESKY, ALAN A | PRESIDENT | 404 10TH AVE W, PALMETTO, FL 34221-5032 |
| Name | Role | Address |
|---|---|---|
| LOVESKY, LORI A | Vice President | 2450 DESOTO ROAD, SARASOTA, FL 34234 |
| Name | Role | Address |
|---|---|---|
| JACKSON, LADONNA R | Chief Executive Officer | 2013 27TH ST W, BRADENTON, FL 34205 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2021-04-13 | 2450 Desoto Rd, Sarasota, FL 34234 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-13 | 404 10th Ave W, Palmetto, FL 34221 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-04-13 | Lovesky, Alan A | No data |
| REINSTATEMENT | 2017-10-23 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2012-01-05 | 404 10th Ave W, Palmetto, FL 34221 | No data |
| REINSTATEMENT | 2011-02-16 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-07-30 |
| ANNUAL REPORT | 2024-01-24 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-01-31 |
| ANNUAL REPORT | 2021-04-13 |
| ANNUAL REPORT | 2020-06-29 |
| ANNUAL REPORT | 2019-02-12 |
| ANNUAL REPORT | 2018-03-27 |
| REINSTATEMENT | 2017-10-23 |
| ANNUAL REPORT | 2016-04-08 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
