| Entity Name: | STERILE COMPOUNDING PHARMACY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 13 Aug 2013 (12 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | L13000113871 |
| FEI/EIN Number | 46-3407272 |
| Address: | 5546 1ST AVE. N., ST. PETERSBURG, FL, 33710, US |
| Mail Address: | 5546 1ST AVE. N., ST. PETERSBURG, FL, 33710, US |
| ZIP code: | 33710 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | STERILE COMPOUNDING PHARMACY, LLC, ALABAMA | 000-329-334 | ALABAMA |
| Headquarter of | STERILE COMPOUNDING PHARMACY, LLC, NEW YORK | 4700107 | NEW YORK |
| Headquarter of | STERILE COMPOUNDING PHARMACY, LLC, ILLINOIS | LLC_04961366 | ILLINOIS |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245625821 | 2015-04-01 | 2015-04-01 | 7381 114TH AVE, SUITE 405A, LARGO, FL, 337735131, US | 7381 114TH AVE, SUITE 405A, LARGO, FL, 337735131, US | |||||||||||||||||||||||
|
|||||||||||||||||||||||||||
| Phone | +1 727-474-8381 |
| Fax | 7276230935 |
Authorized person
| Name | TYLER GUSTMAN |
| Role | PHARMACIST |
| Phone | 8552513874 |
Taxonomy
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| License Number | PH27507 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2151078 |
| Name | Role | Address |
|---|---|---|
| CHEATHAM RUSSELL LIII | Agent | 5546 1ST AVE. N, ST. PETERSBURG, FL, 33710 |
| Name | Role | Address |
|---|---|---|
| CHEATHAM RUSSELL LIII | Manager | 5546 1ST AVE N, ST. PETERSBURG, FL, 33770 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000098042 | SCP, LLC | EXPIRED | 2013-10-03 | 2018-12-31 | No data | 7381 114TH N, SUITE 405A, LARGO, FL, 33773 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2016-02-29 | 5546 1ST AVE. N., ST. PETERSBURG, FL 33710 | No data |
| CHANGE OF MAILING ADDRESS | 2016-02-29 | 5546 1ST AVE. N., ST. PETERSBURG, FL 33710 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-02-29 |
| ANNUAL REPORT | 2015-04-13 |
| ANNUAL REPORT | 2014-04-15 |
| Florida Limited Liability | 2013-08-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
