| Entity Name: | Magellan Healthcare Provider Group, Inc. |
| Jurisdiction: | Connecticut |
| Legal type: | Stock |
| Citizenship: | Foreign |
| Status: | Active |
| Sub status: | Annual report due |
| Date Formed: | 20 Jun 2022 |
| Business ALEI: | 2584490 |
| Annual report due: | 20 Jun 2025 |
| NAICS code: | 524210 - Insurance Agencies and Brokerages |
| Business address: | 8621 Robert Fulton Dr, Columbia, MD, 21046, United States |
| Mailing address: | 8621 Robert Fulton Dr, Columbia, MD, United States, 21046 |
| Place of Formation: | MARYLAND |
| E-Mail: | shannon.p.kister@centene.com |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| Derrick Duke | Officer | 8621 Robert Fulton Dr, Columbia, MD, 21046, United States | 8621 ROBERT FULTON DRIVE, COLUMBIA, MD, 21046, United States |
| Camille Guillot | Officer | 8621 Robert Fulton Dr, Columbia, MD, 21046, United States | 8621 ROBERT FULTON DRIVE, COLUMBIA, MD, 21046, United States |
| Michael McQuillen | Officer | 8621 Robert Fulton Dr, Columbia, MD, 21046, United States | 8621 Robert Fulton Dr, Columbia, MD, 21046-2620, United States |
| Caroline Becker | Officer | 8621 Robert Fulton Dr, Columbia, MD, 21046, United States | 8621 Robert Fulton Dr, Columbia, MD, 21046, United States |
| Name | Role | Business address | Residence address |
|---|---|---|---|
| Derrick Duke | Director | 8621 Robert Fulton Dr, Columbia, MD, 21046, United States | 8621 ROBERT FULTON DRIVE, COLUMBIA, MD, 21046, United States |
| Michael McQuillen | Director | 8621 Robert Fulton Dr, Columbia, MD, 21046, United States | 8621 Robert Fulton Dr, Columbia, MD, 21046-2620, United States |
| Filing number | Filing date | Effective date | Filing category | Filing type | Report year |
|---|---|---|---|---|---|
| BF-0012328657 | 2024-06-04 | No data | Annual Report | Annual Report | No data |
| BF-0011522041 | 2023-06-08 | No data | Annual Report | Annual Report | No data |
| BF-0010646926 | 2022-06-20 | No data | Business Registration | Certificate of Authority | No data |
Date of last update: 25 Nov 2024
Sources: Connecticut's Official State Website
