| Entity Name: | HEARTLAND MEDICAL SUPPLY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 21 Nov 1994 (30 years ago) |
| Document Number: | P94000085843 |
| FEI/EIN Number | 650545389 |
| Address: | 1707 DIVOT LANE, SEBRING, FL, 33872, US |
| Mail Address: | 1707 DIVOT LANE, SEBRING, FL, 33872-3888, US |
| ZIP code: | 33872 |
| County: | Highlands |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1740323658 | 2007-02-14 | 2007-10-09 | 6360 US 27 N, SEBRING, FL, 338701225, US | 204 US 27 S, LAKE PLACID, FL, 338527900, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 863-699-6155 |
| Fax | 8634659656 |
Authorized person
| Name | ROBERT DUNCAN |
| Role | OWNER AND PRESIDENT |
| Phone | 8633857673 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH15581 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336H0001X - Home Infusion Therapy Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | OTHER ID NUMBER |
| Number | 1083663 |
| Name | Role | Address |
|---|---|---|
| DUNCAN ROBERT E | Agent | 1707 DIVOT LANE, SEBRING, FL, 33872 |
| Name | Role | Address |
|---|---|---|
| DUNCAN ROBERT E | President | 1707 DIVOT LANE, SEBRING, FL, 33872 |
| Name | Role | Address |
|---|---|---|
| DUNCAN CAROLINE W | Secretary | 1707 DIVOT LANE, SEBRING, FL, 33872 |
| Name | Role | Address |
|---|---|---|
| DUNCAN CAROLINE W | Treasurer | 1707 DIVOT LANE, SEBRING, FL, 33872 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
