| Entity Name: | FT. MEADE COMMUNITY PHARMACY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 16 Nov 2005 (19 years ago) |
| Date of dissolution: | 23 Sep 2011 (13 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2011 (13 years ago) |
| Document Number: | P05000152216 |
| FEI/EIN Number | 20-3793751 |
| Mail Address: | 2003 RYAN RD, MULBERRY, FL 33860 |
| Address: | 107 W BROADWAY ST, STE B, FT MEADE, FL 33841 |
| ZIP code: | 33841 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1548275159 | 2006-07-30 | 2010-06-30 | 107 W BROADWAY ST STE B, FORT MEADE, FL, 338413300, US | 107 W BROADWAY ST STE B, FORT MEADE, FL, 338413300, US | |||||||||||||||||||||||||||
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| Phone | +1 863-285-9285 |
| Fax | 8632859982 |
Authorized person
| Name | JOHN JOHNSON |
| Role | OWNER |
| Phone | 8632859285 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH21788 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 1017525 |
| Name | Role | Address |
|---|---|---|
| CAMPBELL, TIMOTHY F | Agent | 500 SOUTH FLORIDA AVENUE, SUITE 800, LAKELAND, FL 33801 |
| Name | Role | Address |
|---|---|---|
| JOHNSON, JOHN J | Director | 2003 RYAN RD, MULBERRY, FL 33860 |
| Name | Role | Address |
|---|---|---|
| JOHNSON, JOHN J | President | 2003 RYAN RD, MULBERRY, FL 33860 |
| Name | Role | Address |
|---|---|---|
| JOHNSON, JOHN J | Treasurer | 2003 RYAN RD, MULBERRY, FL 33860 |
| Name | Role | Address |
|---|---|---|
| JOHNSON, JOHN J | Secretary | 2003 RYAN RD, MULBERRY, FL 33860 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| REINSTATEMENT | 2010-11-01 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2010-11-01 | 107 W BROADWAY ST, STE B, FT MEADE, FL 33841 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2010-09-24 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-04-26 | 107 W BROADWAY ST, STE B, FT MEADE, FL 33841 | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2010-11-01 |
| ANNUAL REPORT | 2009-04-21 |
| ANNUAL REPORT | 2008-04-27 |
| ANNUAL REPORT | 2007-04-16 |
| ANNUAL REPORT | 2006-04-26 |
| Domestic Profit | 2005-11-16 |
Date of last update: 03 Jan 2025
Sources: Florida Department of State
