| Entity Name: | KEMPCARE INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 01 May 2020 (5 years ago) |
| Date of dissolution: | 23 Sep 2022 (2 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2022 (2 years ago) |
| Document Number: | P20000033386 |
| FEI/EIN Number | APPLIED FOR |
| Address: | 400 PARROT AVE, SEBRING, FLORIDA, US, 34870, US |
| Mail Address: | 840 US HIGHWAY 1, SUITE 435C, NORTH PALM BEACH, AL, 33408, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1871115436 | 2020-05-17 | 2020-05-17 | 840 US HIGHWAY 1 STE 435C, N PALM BEACH, FL, 334083829, US | 840 US HIGHWAY 1 STE 435C, N PALM BEACH, FL, 334083829, US | |||||||||||||||||||||
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| Phone | +1 561-294-7741 |
| Fax | 5618051097 |
Authorized person
| Name | AYANNA BABCOCK SUTHERLAND |
| Role | CEO/FOUNDER |
| Phone | 5612947741 |
Taxonomy
| Taxonomy Code | 332900000X - Non-Pharmacy Dispensing Site |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 0108130000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SUTHERLAND AYANNA B | Agent | 4440 PGA BLVD, PALM BEACH GARDENS, FL, 33410 |
| Name | Role | Address |
|---|---|---|
| SUTHERLAND ALYIAH E | Vice President | 840 US Highway 1, NORTH PALM BEACH, FL, 33408 |
| Name | Role | Address |
|---|---|---|
| SUTHERLAND ANAIAH A | Chief Financial Officer | 4440 US HIGHWAY 1 SUITE 600, PALM BEACH GARDENS, FL, 33410 |
| Name | Role | Address |
|---|---|---|
| SUTHERLAND AYANNA B | Chief Executive Officer | 840 US Highway 1, NORTH PALM BEACH, FL, 33408 |
| Name | Role | Address |
|---|---|---|
| MARION ANTHONY T | President | 840 US HIGHWAY 1 SUITE 435C, NORTH PALM BEACH, FL, 33408 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2021-04-30 | 400 PARROT AVE, SEBRING, FLORIDA, US 34870 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2021-04-30 |
| Domestic Profit | 2020-05-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
