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  5. PREMIER COMPOUNDING PHARMACY, INC.

PREMIER COMPOUNDING PHARMACY, INC.

Company Details

Entity Name: PREMIER COMPOUNDING PHARMACY, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 09 Jul 2007 (18 years ago)
Last Event: CANCEL ADM DISS/REV
Event Date Filed: 15 Oct 2009 (15 years ago)
Document Number: P07000077986
FEI/EIN Number 260490222
Address: 2000 PGA BLVD., 5507, PALM BEACH GARDENS, FL, 33408, US
Mail Address: 2000 PGA BLVD., 5507, PALM BEACH GARDENS, FL, 33408, US
ZIP code: 33408
County: Palm Beach
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1205377173 2017-03-13 2018-06-16 2000 PGA BLVD., SUITE 5507, PALM BEACH GARDENS, FL, 33408, US 2000 PGA BLVD., SUITE 5507, PALM BEACH GARDENS, FL, 33408, US

Contacts
Phone +1 888-507-8621

Authorized person
Name TRACY CHRISTIAN
Role PRESIDENT/CEO/OWNER
Phone 8885078621

Taxonomy
Taxonomy Code 333600000X - Pharmacy
Is Primary No
Taxonomy Code 3336L0003X - Long Term Care Pharmacy
License Number PH23481
State FL
Is Primary Yes

Other Provider Identifiers
Issuer PK
Number 2168181

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PREMIER COMPOUNDING PHARMACY 401(K) PLAN 2023 260490222 2024-04-19 PREMIER COMPOUNDING PHARMACY 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 325410
Sponsor’s telephone number 5616914991
Plan sponsor’s address 2000 PGA BLVD., SUITE 5507, PALM BEACH GARDENS, FL, 33408
PREMIER COMPOUNDING PHARMACY 401(K) PLAN 2022 260490222 2023-10-09 PREMIER COMPOUNDING PHARMACY 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 325410
Sponsor’s telephone number 5616914991
Plan sponsor’s address 2000 PGA BLVD., SUITE 5507, PALM BEACH GARDENS, FL, 33408
PREMIER COMPOUNDING PHARMACY 401(K) PLAN 2021 260490222 2022-10-26 PREMIER COMPOUNDING PHARMACY 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 325410
Sponsor’s telephone number 5616914991
Plan sponsor’s address 2000 PGA BLVD., SUITE 5507, PALM BEACH GARDENS, FL, 33408
PREMIER COMPOUNDING PHARMACY 401(K) PLAN 2020 260490222 2021-09-27 PREMIER COMPOUNDING PHARMACY 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 325410
Sponsor’s telephone number 5616914991
Plan sponsor’s address 2000 PGA BLVD., SUITE 5507, PALM BEACH GARDENS, FL, 33408
PREMIER COMPOUNDING PHARMACY 401(K) PLAN 2019 260490222 2020-10-09 PREMIER COMPOUNDING PHARMACY 26
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 325412
Sponsor’s telephone number 5616914991
Plan sponsor’s address 2000 PGA BLVD., SUITE 5507, PALM BEACH GARDENS, FL, 33408
PREMIER COMPOUNDING PHARMACY 401(K) PLAN 2017 260490222 2018-10-12 PREMIER COMPOUNDING PHARMACY 56
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 325410
Sponsor’s telephone number 5616914991
Plan sponsor’s address 2000 PGA BLVD., SUITE 5507, PALM BEACH GARDENS, FL, 33408
PREMIER COMPOUNDING PHARMACY 401(K) PLAN 2016 260490222 2018-01-30 PREMIER COMPOUNDING PHARMACY 66
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 325410
Sponsor’s telephone number 5616914991
Plan sponsor’s address 2000 PGA BLVD., SUITE 5507, PALM BEACH GARDENS, FL, 33408
PREMIER COMPOUNDING PHARMACY 401(K) PLAN 2015 260490222 2016-08-05 PREMIER COMPOUNDING PHARMACY 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 325410
Sponsor’s telephone number 5616914991
Plan sponsor’s address 2000 PGA BLVD., SUITE 5507, PALM BEACH GARDENS, FL, 33408
PREMIER COMPOUNDING PHARMACY 401(K) PLAN 2014 260490222 2015-10-15 PREMIER COMPOUNDING PHARMACY 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-01-01
Business code 325410
Sponsor’s telephone number 5616914991
Plan sponsor’s address 2000 PGA BLVD., SUITE 5507, PALM BEACH GARDENS, FL, 33408

Agent

Name Role Address
CHRISTIAN TRACY L Agent 2000 PGA BLVD., SUITE 5507, PALM BEACH GARDENS, FL, 33408

President

Name Role Address
CHRISTIAN TRACY L President 2000 PGA BLVD., SUITE 5507, PALM BEACH GARDENS, FL, 33408

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G17000097310 PREMIER PHARMACY LTC EXPIRED 2017-08-28 2022-12-31 No data 2000 PGA BLVD., SUITE 5507, PALM BEACH GARDENS, FL, 33408
G17000019504 UNITED LTC RX EXPIRED 2017-02-22 2022-12-31 No data 2000 PGA BLVD, SUITE 5508, PALM BEACH GARDENS, FL, 33408
G12000104357 PREMIER CUSTOM PHARMACY EXPIRED 2012-10-26 2017-12-31 No data 2000 PGA BLVD, #5507, PALM BEACH GARDENS, FL, 33408

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2012-12-10 2000 PGA BLVD., SUITE 5507, N/A, PALM BEACH GARDENS, FL 33408 No data
CANCEL ADM DISS/REV 2009-10-15 No data No data
CHANGE OF PRINCIPAL ADDRESS 2009-10-15 2000 PGA BLVD., 5507, PALM BEACH GARDENS, FL 33408 No data
CHANGE OF MAILING ADDRESS 2009-10-15 2000 PGA BLVD., 5507, PALM BEACH GARDENS, FL 33408 No data
ADMIN DISSOLUTION FOR ANNUAL REPORT 2009-09-25 No data No data

Documents

Name Date
ANNUAL REPORT 2024-06-03
ANNUAL REPORT 2023-03-07
ANNUAL REPORT 2022-03-14
ANNUAL REPORT 2021-03-18
ANNUAL REPORT 2020-01-22
ANNUAL REPORT 2019-02-08
ANNUAL REPORT 2018-01-12
ANNUAL REPORT 2017-02-08
ANNUAL REPORT 2016-04-27
ANNUAL REPORT 2015-01-27

Related by officers

CHRISTIAN TRACY L

FOREFRONT LABORATORIES, LLC PREMIER RX REPACKS, LLC PREMIER CUSTOM, CO. A PREMIER HEALTH SOLUTION, INC. JUPITER FLORIST, INC. MEDICINE EXPRESS, INC.

Related by address

2000 PGA BLVD., 5507, PALM BEACH GARDENS, FL, 33408, US

A PREMIER HEALTH SOLUTION, INC.

2000 PGA BLVD., 5507, PALM BEACH GARDENS, FL, 33408, US

A PREMIER HEALTH SOLUTION, INC.

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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