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  5. KUSTOM WELLNESS, INC.

KUSTOM WELLNESS, INC. - Florida Company Profile

Company Details

Entity Name: KUSTOM WELLNESS, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit

KUSTOM WELLNESS, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act.
Status: Active

The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness.

Date Filed: 19 Apr 2017 (8 years ago)
Document Number: P17000035511
FEI/EIN Number 82-1378435

Federal Employer Identification (FEI) Number assigned by the IRS.
Address: 4550 DONALD ROSS ROAD, 113, PALM BEACH GARDENS, FL, 33418
Mail Address: 4550 DONALD ROSS ROAD, 113, PALM BEACH GARDENS, FL, 33418, US
ZIP code: 33418
County: Palm Beach
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1710403043 2017-08-18 2022-07-21 4550 DONALD ROSS RD STE 113, PALM BEACH GARDENS, FL, 334185104, US 4550 DONALD ROSS RD STE 113, PALM BEACH GARDENS, FL, 334185104, US

Contacts
Phone +1 561-469-1558

Authorized person
Name DR. TRACY KIRKPATRICK
Role PRESIDENT
Phone 5614691558

Taxonomy
Taxonomy Code 333600000X - Pharmacy
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
KUSTOM WELLNESS, INC. 401(K) P/S PLAN 2022 821378435 2023-11-01 KUSTOM WELLNESS, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 446110
Sponsor’s telephone number 5084317438
Plan sponsor’s address 4550 DONALD ROSS RD STE 113, PALM BEACH GARDENS, FL, 33418

Plan administrator’s name and address
Administrator’s EIN 821378435
Plan administrator’s name KUSTOM WELLNESS, INC.
Plan administrator’s address 4550 DONALD ROSS RD STE 113, PALM BEACH GARDENS, FL, 33418
Administrator’s telephone number 5084317438

Signature of
Role Plan administrator
Date 2023-11-01
Name of individual signing HOWARD KIRKPATRICK
Valid signature Filed with authorized/valid electronic signature
KUSTOM WELLNESS, INC. 401(K) P/S PLAN 2021 821378435 2023-03-27 KUSTOM WELLNESS, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 446110
Sponsor’s telephone number 5084317438
Plan sponsor’s address 4550 DONALD ROSS RD STE 113, PALM BEACH GARDENS, FL, 33418

Plan administrator’s name and address
Administrator’s EIN 821378435
Plan administrator’s name KUSTOM WELLNESS, INC.
Plan administrator’s address 4550 DONALD ROSS RD STE 113, PALM BEACH GARDENS, FL, 33418
Administrator’s telephone number 5084317438

Signature of
Role Plan administrator
Date 2023-03-27
Name of individual signing HOWARD KIRKPATRICK
Valid signature Filed with authorized/valid electronic signature
KUSTOM WELLNESS, INC. 401(K) P/S PLAN 2020 821378435 2021-07-29 KUSTOM WELLNESS, INC. 3
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 446110
Sponsor’s telephone number 5084317438
Plan sponsor’s address 4550 DONALD ROSS RD STE 113, PALM BEACH GARDENS, FL, 33418

Plan administrator’s name and address
Administrator’s EIN 821378435
Plan administrator’s name KUSTOM WELLNESS, INC.
Plan administrator’s address 4550 DONALD ROSS RD STE 113, PALM BEACH GARDENS, FL, 33418
Administrator’s telephone number 5084317438

Signature of
Role Plan administrator
Date 2021-07-29
Name of individual signing HOWARD KIRKPATRICK
Valid signature Filed with authorized/valid electronic signature
KUSTOM WELLNESS, INC. 401(K) P/S PLAN 2019 821378435 2020-12-30 KUSTOM WELLNESS, INC. 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 446110
Sponsor’s telephone number 5084317438
Plan sponsor’s address 4550 DONALD ROSS RD STE 113, PALM BEACH GARDENS, FL, 33418

Plan administrator’s name and address
Administrator’s EIN 821378435
Plan administrator’s name KUSTOM WELLNESS, INC.
Plan administrator’s address 4550 DONALD ROSS RD STE 113, PALM BEACH GARDENS, FL, 33418
Administrator’s telephone number 5084317438

Signature of
Role Plan administrator
Date 2020-12-30
Name of individual signing HOWARD KIRKPATRICK
Valid signature Filed with authorized/valid electronic signature
KUSTOM WELLNESS, INC. 401(K) P/S PLAN 2018 821378435 2020-11-15 KUSTOM WELLNESS, INC. 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2018-01-01
Business code 446110
Sponsor’s telephone number 5084317438
Plan sponsor’s address 4550 DONALD ROSS RD STE 113, PALM BEACH GARDENS, FL, 33418

Plan administrator’s name and address
Administrator’s EIN 821378435
Plan administrator’s name KUSTOM WELLNESS, INC.
Plan administrator’s address 4550 DONALD ROSS RD STE 113, PALM BEACH GARDENS, FL, 33418
Administrator’s telephone number 5084317438

Signature of
Role Plan administrator
Date 2020-11-15
Name of individual signing HOWARD KIRKPATRICK
Valid signature Filed with authorized/valid electronic signature

Key Officers & Management

Name Role Address
KIRKPATRICK LAW FIRM Agent 105 PRINCEWOOD LN, PALM BCH GDNS, FL, 33410
KIRKPATRICK TRACY President 105 Princewood Lane, Palm Beach Gardens, FL, 33410
KIRKPATRICK HOWARD Vice President 105 Princewood Lane, Palm Beach Gardens, FL, 33410

Events

Event Type Filed Date Value Description
REGISTERED AGENT ADDRESS CHANGED 2023-01-05 105 PRINCEWOOD LN, PALM BCH GDNS, FL 33410 -
CHANGE OF MAILING ADDRESS 2018-04-30 4550 DONALD ROSS ROAD, 113, PALM BEACH GARDENS, FL 33418 -

Documents

Name Date
ANNUAL REPORT 2024-02-06
ANNUAL REPORT 2023-01-05
ANNUAL REPORT 2022-01-21
ANNUAL REPORT 2021-01-27
ANNUAL REPORT 2020-07-21
ANNUAL REPORT 2019-04-26
AMENDED ANNUAL REPORT 2018-04-30
ANNUAL REPORT 2018-02-18
Domestic Profit 2017-04-19

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
1168917103 2020-04-10 0455 PPP 4550 Donald Ross Village Ste 113, PALM BEACH GARDENS, FL, 33410
Loan Status Date 2021-06-17
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 11000
Loan Approval Amount (current) 11000
Undisbursed Amount 0
Franchise Name -
Lender Location ID 17124
Servicing Lender Name City National Bank of Florida
Servicing Lender Address 100 SE 2nd St, MIAMI, FL, 33131
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address PALM BEACH GARDENS, PALM BEACH, FL, 33410-1000
Project Congressional District FL-21
Number of Employees 2
NAICS code 446110
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Subchapter S Corporation
Originating Lender ID 17124
Originating Lender Name City National Bank of Florida
Originating Lender Address MIAMI, FL
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 11116.63
Forgiveness Paid Date 2021-05-17

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Companies related by address

No other companies in our directory share the same address as KUSTOM WELLNESS, INC.

Date of last update: 01 Mar 2025

Sources: Florida Department of State

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