| Entity Name: | LIFE EXTENSION PHARMACY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Profit Corporation |
| Status: | Inactive |
| Date Filed: | 04 Jan 2006 (19 years ago) |
| Date of dissolution: | 27 Jan 2020 (5 years ago) |
| Last Event: | WITHDRAWAL |
| Event Date Filed: | 27 Jan 2020 (5 years ago) |
| Document Number: | F06000000069 |
| FEI/EIN Number | 20-4006694 |
| Address: | 5990 NORTH FEDERAL HIGHWAY, FT. LAUDERDALE, FL 33308 |
| Mail Address: | 5990 NORTH FEDERAL HIGHWAY, FT. LAUDERDALE, FL 33308 |
| ZIP code: | 33308 |
| County: | Broward |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1467530873 | 2006-11-02 | 2015-03-04 | 3600 W COMMERCIAL BLVD, FORT LAUDERDALE, FL, 333093338, US | 5990 N FEDERAL HWY, FORT LAUDERDALE, FL, 333082633, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 954-202-7729 |
| Fax | 9542027729 |
| Phone | +1 877-877-9700 |
| Fax | 8778779708 |
Authorized person
| Name | MELANIE KAMBURIAN |
| Role | PARALEGAL |
| Phone | 9542027729 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH22301 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336M0002X - Mail Order Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | PK |
| Number | 2007736 |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 1200 S PINE ISLAND RD, PLANTATION, FL 33324 |
| Name | Role | Address |
|---|---|---|
| FALOON, WILLIAM | Director | 3600 W. COMMERCIAL BLVD, LAUDERDALE, FL 33309 |
| Name | Role | Address |
|---|---|---|
| MURRAY, JAMES D | President | 3600 W. COMMERCIAL BLVD., LAUDERDALE, FL 33309 |
| Name | Role | Address |
|---|---|---|
| MURRAY, JAMES D | Secretary | 3600 W. COMMERCIAL BLVD., LAUDERDALE, FL 33309 |
| Name | Role | Address |
|---|---|---|
| MURRAY, JAMES D | Treasurer | 3600 W. COMMERCIAL BLVD., LAUDERDALE, FL 33309 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| WITHDRAWAL | 2020-01-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-02-29 | 5990 NORTH FEDERAL HIGHWAY, FT. LAUDERDALE, FL 33308 | No data |
| CHANGE OF MAILING ADDRESS | 2012-02-29 | 5990 NORTH FEDERAL HIGHWAY, FT. LAUDERDALE, FL 33308 | No data |
| Name | Date |
|---|---|
| Withdrawal | 2020-01-27 |
| ANNUAL REPORT | 2019-04-08 |
| ANNUAL REPORT | 2018-03-26 |
| ANNUAL REPORT | 2017-04-13 |
| ANNUAL REPORT | 2016-03-08 |
| ANNUAL REPORT | 2015-01-06 |
| ANNUAL REPORT | 2014-02-19 |
| ANNUAL REPORT | 2013-04-02 |
| ANNUAL REPORT | 2012-02-29 |
| ANNUAL REPORT | 2011-01-07 |
Date of last update: 28 Jan 2025
Sources: Florida Department of State
