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UMATILLA PHARMACY INC. - Florida Company Profile

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Company Details

Entity Name: UMATILLA PHARMACY INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 15 May 2024 (a year ago)
Document Number: P24000034529
FEI/EIN Number 38-4320606
Mail Address: PO Box 1250, San Antonio, FL, 33576, US
Address: 901 N. CENTRAL AVE., UMATILLA, FL, 32784
ZIP code: 32784
City: Umatilla
County: Lake
Place of Formation: FLORIDA

Key Officers & Management

Name Role Address
CORKREAN SEAN P Chief Executive Officer 32713 COUNTY ROAD 473, LEESBURG, FL, 34788
CORKREAN SHANNON M President PO BOX 1250, SAN ANTONIO, FL, 33576
CORKREAN SEAN P Agent 32713 COUNTY ROAD 473, LEESBURG, FL, 34788

National Provider Identifier

NPI Number:
1871325241
Certification Date:
2024-08-15

Authorized Person:

Name:
SHANNON CORKREAN
Role:
PRESIDENT
Phone:

Taxonomy:

Selected Taxonomy:
3336C0003X - Community/Retail Pharmacy
Is Primary:
Yes

Contacts:

Fax:
3526698866

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2025-02-06 901 N. CENTRAL AVE., UMATILLA, FL 32784 -

Documents

Name Date
ANNUAL REPORT 2025-02-06
Domestic Profit 2024-05-15

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Date of last update: 03 Aug 2025

Sources: Florida Department of State