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CRESTVIEW PHARMACY, LLC - Florida Company Profile

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Company Details

Entity Name: CRESTVIEW PHARMACY, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Inactive
Date Filed: 11 Dec 2018 (7 years ago)
Date of dissolution: 23 Oct 2024 (10 months ago)
Last Event: VOLUNTARY DISSOLUTION
Event Date Filed: 23 Oct 2024 (10 months ago)
Document Number: L18000284682
FEI/EIN Number NOT APPLICABLE
Address: 1116 N. FERDON BLVD., CRESTVIEW, FL, 32536, US
Mail Address: 1420 KENSINGTON RD., SUITE 102, OAK BROOK, IL, 60523, US
ZIP code: 32536
City: Crestview
County: Okaloosa
Place of Formation: FLORIDA

Links between entities

Type:
Headquarter of
Company Number:
000-826-193
State:
ALABAMA

Key Officers & Management

Name Role Address
Optio Rx, LLC Member 1420 KENSINGTON RD., OAK BROOK, IL, 60523
Corporation Service Compan Agent 1201 Hays Street, Tallahassee, FL, 32301

National Provider Identifier

NPI Number:
1407965262

Authorized Person:

Name:
MR. VINCE DAGRAVA
Role:
COO
Phone:

Taxonomy:

Selected Taxonomy:
3336C0003X - Community/Retail Pharmacy
Is Primary:
Yes

Contacts:

Fax:
8506831753

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G21000005057 CRESTVIEW PHARMACY ACTIVE 2021-01-11 2026-12-31 - 1116 N FERDON BLVD, CRESTVIEW, FL, 32536

Events

Event Type Filed Date Value Description
VOLUNTARY DISSOLUTION 2024-10-23 - -
CHANGE OF PRINCIPAL ADDRESS 2023-04-25 1116 N. FERDON BLVD., CRESTVIEW, FL 32536 -
CHANGE OF MAILING ADDRESS 2023-04-25 1116 N. FERDON BLVD., CRESTVIEW, FL 32536 -
REINSTATEMENT 2021-12-13 - -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2021-09-24 - -
REGISTERED AGENT ADDRESS CHANGED 2020-01-03 1201 Hays Street, Tallahassee, FL 32301 -
REINSTATEMENT 2020-01-03 - -
REGISTERED AGENT NAME CHANGED 2020-01-03 Corporation Service Compan -
ADMIN DISSOLUTION FOR ANNUAL REPORT 2019-09-27 - -
CONVERSION 2018-12-11 - CORPORATION WAS A CONVERSION RESULT. CONVERTING CORPORATION WAS P01000048343. CONVERSION NUMBER 500000187625

Documents

Name Date
VOLUNTARY DISSOLUTION 2024-10-23
ANNUAL REPORT 2024-02-13
ANNUAL REPORT 2023-04-25
ANNUAL REPORT 2022-03-07
REINSTATEMENT 2021-12-13
REINSTATEMENT 2020-01-03
Florida Limited Liability 2018-12-11

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Date of last update: 01 Aug 2025

Sources: Florida Department of State