| Entity Name: | NATIONAL COMPOUNDING COMPANY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 21 Jun 2012 (13 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | P12000056146 |
| FEI/EIN Number | APPLIED FOR |
| Address: | 1003 8TH AVENUE W, BRADENTON, FL 34205 |
| Mail Address: | 1003 8TH AVENUE W, BRADENTON, FL 34205 |
| ZIP code: | 34205 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | NATIONAL COMPOUNDING COMPANY, INC., NEW YORK | 4360632 | NEW YORK |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649516113 | 2013-01-02 | 2013-01-24 | 1824 59TH ST W, BRADENTON, FL, 342094630, US | 1824 59TH ST W, BRADENTON, FL, 342094630, US | |||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||
| Phone | +1 941-792-2688 |
| Fax | 9412544937 |
Authorized person
| Name | BRAD LONG |
| Role | PRESIDENT |
| Phone | 9417922688 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH26591 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336M0002X - Mail Order Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 5712965 |
| Name | Role |
|---|---|
| BLALOCK WALTERS, P.A. | Agent |
| Name | Role | Address |
|---|---|---|
| DESTEFANO, FRANK | Treasurer | 1003 8TH AVENUE W, BRADENTON, FL 34205 |
| Name | Role | Address |
|---|---|---|
| DESTEFANO, FRANK | President | 1003 8TH AVENUE W, BRADENTON, FL 34205 |
| Name | Role | Address |
|---|---|---|
| LONG, BRAD E | Secretary | 1003 8TH AVENUE W, BRADENTON, FL 34205 |
| Name | Role | Address |
|---|---|---|
| LONG, BRAD E | Director | 1003 8TH AVENUE W, BRADENTON, FL 34205 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000047583 | SOOTHE PERSONALIZED RX | EXPIRED | 2014-05-14 | 2019-12-31 | No data | 11047 GATEWOOD DRIVE, BRADENTON, FL, 34211 |
| G12000115523 | BRADENTON FAMILY PHARMACY OF FL | EXPIRED | 2012-12-03 | 2017-12-31 | No data | 5099 ASHLEY PARKWAY, SARASOTA, FL, 34241 |
| G12000115530 | DAVID M. WILLIAMS, LLC, OF FL | EXPIRED | 2012-12-03 | 2017-12-31 | No data | 5099 ASHLEY PARKWAY, SARASOTA, FL, 34241 |
| G12000107752 | SOOTHE COMPOUNDING PHARMACY | EXPIRED | 2012-11-07 | 2017-12-31 | No data | 5099 ASHLEY PARKWAY, SARASOTA, FL, 34241 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2025-08-01 | 1003 8TH AVENUE W, BRADENTON, FL 34205 | No data |
| CHANGE OF MAILING ADDRESS | 2024-08-01 | 1003 8TH AVENUE W, BRADENTON, FL 34205 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2014-08-21 | 1003 8TH AVENUE W, BRADENTON, FL 34205 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-02-16 |
| ANNUAL REPORT | 2015-04-27 |
| ANNUAL REPORT | 2014-03-26 |
| ANNUAL REPORT | 2013-02-07 |
| Domestic Profit | 2012-06-21 |
Date of last update: 23 Jan 2025
Sources: Florida Department of State
