| Entity Name: | STEVERSON PHARMACY SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 21 Jan 2005 (20 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 17 Oct 2011 (13 years ago) |
| Document Number: | P05000011279 |
| FEI/EIN Number | 010826626 |
| Address: | 1242 MAIN STREET, CHIPLEY, FL, 32428, US |
| Mail Address: | 1242 MAIN STREET, CHIPLEY, FL, 32428, US |
| ZIP code: | 32428 |
| County: | Washington |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902397946 | 2018-05-25 | 2018-07-19 | 1242 MAIN ST, CHIPLEY, FL, 324282471, US | 1242 MAIN ST, CHIPLEY, FL, 324282471, US | |||||||||||||||||||||||||||||||||
|
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| Phone | +1 850-638-4875 |
| Fax | 8506389195 |
Authorized person
| Name | WILLIAM STEVERSON |
| Role | OWNER PHARMACIST |
| Phone | 8506384875 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| License Number | PH21131 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 0283444-00 |
| State | FL |
| Issuer | PK |
| Number | 2177819 |
| Name | Role | Address |
|---|---|---|
| STEVERSON WILLIAM L | Agent | 1242 MAIN STREET, CHIPLEY, FL, 32428 |
| Name | Role | Address |
|---|---|---|
| STEVERSON WILLIAM L | President | 1242 MAIN STREET, CHIPLEY, FL, 32428 |
| Name | Role | Address |
|---|---|---|
| STEVERSON WILLIAM L | Secretary | 1242 MAIN STREET, CHIPLEY, FL, 32428 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000009443 | KING OUTDOORS ONLINE | ACTIVE | 2023-01-20 | 2028-12-31 | No data | 1242 MAIN STREET, CHIPLEY, FL, 32428 |
| G21000092122 | KINGS DISCOUNT DRUG | ACTIVE | 2021-07-14 | 2026-12-31 | No data | 1242 MAIN STREET, CHIPLEY, FL, 32428 |
| G19000086434 | KING OUTDOORS | ACTIVE | 2019-08-15 | 2029-12-31 | No data | 1242 MAIN STREET, CHIPLEY, FL, 32428 |
| G09071900383 | KING DISCOUNT DRUG | ACTIVE | 2009-03-12 | 2029-12-31 | No data | 1242 MAIN STREET, CHIPLEY, FL, 32428 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2011-10-17 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2011-10-17 | 1242 MAIN STREET, CHIPLEY, FL 32428 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-10-17 | 1242 MAIN STREET, CHIPLEY, FL 32428 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-10-17 | 1242 MAIN STREET, CHIPLEY, FL 32428 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-28 |
| ANNUAL REPORT | 2024-02-01 |
| ANNUAL REPORT | 2023-01-25 |
| ANNUAL REPORT | 2022-02-02 |
| ANNUAL REPORT | 2021-01-12 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-02-06 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-02-22 |
| ANNUAL REPORT | 2016-03-08 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
