| Entity Name: | THE CRAYTON-MITCHELL GROUP, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 24 May 2011 (14 years ago) |
| Document Number: | L11000061006 |
| FEI/EIN Number | 45-2387669 |
| Address: | 197 Bouganvillea Drive, Rockledge, FL, 32955, US |
| Mail Address: | 197 Bouganvillea Drive, Rockledge, FL, 32955, US |
| ZIP code: | 32955 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851750178 | 2016-02-15 | 2020-01-28 | 197 BOUGAINVILLEA DR STE D, ROCKLEDGE, FL, 329552402, US | 197 BOUGAINVILLEA DR STE D, ROCKLEDGE, FL, 329552402, US | |||||||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||||||
| Phone | +1 321-636-2275 |
Authorized person
| Name | TRACI MITCHELL |
| Role | OWNER |
| Phone | 3216362275 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | PH29873 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 332BC3200X - Customized Equipment (DME) |
| License Number | PH29873 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH29873 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2158119 |
| Name | Role | Address |
|---|---|---|
| MITCHELL GREGORY D | Agent | 197 Bouganvillea Drive, Rockledge, FL, 32955 |
| Name | Role | Address |
|---|---|---|
| MITCHELL TRACI J | Manager | 197 Bouganvillea Drive, Rockledge, FL, 32955 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000173392 | SPACE COAST COMMUNITY PHARMACY | ACTIVE | 2021-12-29 | 2026-12-31 | No data | 197 BOUGANVILLEA DRIVE, SUITE D, ROCKLEDGE, FL, 32955 |
| G21000060014 | SPACE COAST COMMUNITY PHARMACY | ACTIVE | 2021-05-01 | 2026-12-31 | No data | 197 BOUGANVILLEA DRIVE, SUITE D, ROCKLEDGE, FL, 32955 |
| G15000042869 | SPACE COAST COMMUNITY PHARMACY | EXPIRED | 2015-04-29 | 2020-12-31 | No data | 571 HAVERTY COURT SUITE L, ROCKLEDGE, FL, 32955 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-06-11 | 197 Bouganvillea Drive, Suite D, Rockledge, FL 32955 | No data |
| CHANGE OF MAILING ADDRESS | 2020-06-11 | 197 Bouganvillea Drive, Suite D, Rockledge, FL 32955 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-06-11 | 197 Bouganvillea Drive, Suite D, Rockledge, FL 32955 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-04-06 |
| ANNUAL REPORT | 2021-04-02 |
| ANNUAL REPORT | 2020-06-11 |
| ANNUAL REPORT | 2019-04-22 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-04-28 |
| ANNUAL REPORT | 2016-04-22 |
| ANNUAL REPORT | 2015-04-29 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
