| Entity Name: | BUNNELL PHARMACY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 20 May 1985 (40 years ago) |
| Document Number: | H57689 |
| FEI/EIN Number | 59-2529935 |
| Mail Address: | 3735 CORGAN RD, DELAND, FL 32724 |
| Address: | 703 E. MOODY BLVD, SUITE A, MEDICAL ARTS BLD, BUNNELL, FL 32110 |
| ZIP code: | 32110 |
| County: | Flagler |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194833822 | 2006-08-25 | 2007-09-13 | PO BOX 895, BUNNELL, FL, 321100895, US | 706 E MOODY BLVD, BUNNELL, FL, 321100895, US | |||||||||||||||||||||||||||||||
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| Phone | +1 386-437-3325 |
| Fax | 3864371533 |
Authorized person
| Name | JOSEPH CORGAN |
| Role | OWNER |
| Phone | 3864373325 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH0008958 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | OTHER ID NUMBER |
| Number | 1007790 |
| Name | Role | Address |
|---|---|---|
| CORGAN, JOSEPH SEAN | Agent | 3735 CORGAN RD, DELAND, FL 32724 |
| Name | Role | Address |
|---|---|---|
| CORGAN, JOSEPH | President | 3735 CORGAN RD, DELAND, FL 32724 |
| Name | Role | Address |
|---|---|---|
| CORGAN, JOSEPH | Director | 3735 CORGAN RD, DELAND, FL 32724 |
| Name | Role | Address |
|---|---|---|
| CORGAN, CAROL ANN | DIRECTOR | 3735 CORGAN RD., DELAND, FL 32724 |
| CORGAN, SEAN A, DR. | DIRECTOR | 21 WESTCOTT PARKWAY, ST AUGUSTINE, FL 32095 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-25 | 703 E. MOODY BLVD, SUITE A, MEDICAL ARTS BLD, BUNNELL, FL 32110 | No data |
| REGISTERED AGENT NAME CHANGED | 2020-01-16 | CORGAN, JOSEPH SEAN | No data |
| CHANGE OF MAILING ADDRESS | 2006-01-19 | 703 E. MOODY BLVD, SUITE A, MEDICAL ARTS BLD, BUNNELL, FL 32110 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2006-01-19 | 3735 CORGAN RD, DELAND, FL 32724 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-10 |
| ANNUAL REPORT | 2023-01-25 |
| ANNUAL REPORT | 2022-02-27 |
| ANNUAL REPORT | 2021-02-12 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-02-06 |
| ANNUAL REPORT | 2018-01-28 |
| ANNUAL REPORT | 2017-01-31 |
| ANNUAL REPORT | 2016-02-19 |
| ANNUAL REPORT | 2015-01-19 |
Date of last update: 04 Feb 2025
Sources: Florida Department of State
