| Entity Name: | SUNTREE PHARMACY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 15 Dec 2000 (24 years ago) |
| Date of dissolution: | 12 May 2021 (4 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 12 May 2021 (4 years ago) |
| Document Number: | P00000115969 |
| FEI/EIN Number | 593685368 |
| Address: | 7640 N. WICKHAM RD., SUITE 117, MELBOURNE, FL, 32940, US |
| Mail Address: | 7640 N. WICKHAM RD., SUITE 117, MELBOURNE, FL, 32940, US |
| ZIP code: | 32940 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548329014 | 2006-12-08 | 2023-03-07 | 7640 N. WICKHAM RD #117, MELBOURNE, FL, 32940, US | 7640 N. WICKHAM RD #117, MELBOURNE, FL, 32940, US | |||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 321-253-3535 |
| Fax | 3212532522 |
Authorized person
| Name | MS. DIAHN CLARK |
| Role | OWNER |
| Phone | 3212533535 |
Taxonomy
| Taxonomy Code | 183500000X - Pharmacist |
| License Number | PH18030 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 183500000X - Pharmacist |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PHARMACY LICENSE |
| Number | PH18030 |
| State | FL |
| Issuer | MEDICAID |
| Number | 000042400 |
| State | FL |
| Issuer | MEDICAID |
| Number | 026219600 |
| State | FL |
| Name | Role |
|---|---|
| MEACHAM & CLARK, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| CLARK DIAHN L | President | 7025 N. WICKHAM RD., #113, MELBOURNE, FL, 32940 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2021-05-12 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2013-04-12 | 7640 N. WICKHAM RD., SUITE 117, MELBOURNE, FL 32940 | No data |
| ARTICLES OF CORRECTION | 2012-08-02 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-08-02 | 7640 N. WICKHAM RD., SUITE 117, MELBOURNE, FL 32940 | No data |
| CHANGE OF MAILING ADDRESS | 2012-08-02 | 7640 N. WICKHAM RD., SUITE 117, MELBOURNE, FL 32940 | No data |
| REGISTERED AGENT NAME CHANGED | 2007-01-04 | MEACHAM & CLARK, LLC | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2021-05-12 |
| ANNUAL REPORT | 2020-06-18 |
| ANNUAL REPORT | 2019-04-03 |
| ANNUAL REPORT | 2018-02-16 |
| ANNUAL REPORT | 2017-03-16 |
| ANNUAL REPORT | 2016-01-22 |
| ANNUAL REPORT | 2015-03-12 |
| ANNUAL REPORT | 2014-01-30 |
| ANNUAL REPORT | 2013-04-12 |
| Articles of Correction | 2012-08-02 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
