| Entity Name: | PACIFICO NATIONAL, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
PACIFICO NATIONAL, 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: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 01 Sep 1999 (26 years ago) |
| Date of dissolution: | 27 Sep 2024 (7 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (7 months ago) |
| Document Number: | P99000077969 |
| FEI/EIN Number |
593601043
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 1515 ELIZABETH STREET, SUITE J, MELBOURNE, FL, 32901 |
| Mail Address: | 1515 ELIZABETH STREET, SUITE J, MELBOURNE, FL, 32901 |
| ZIP code: | 32901 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1366416448 | 2006-02-15 | 2017-04-20 | 1515 ELIZABETH ST, STE J, MELBOURNE, FL, 329013000, US | 1515 ELIZABETH ST, STE J, MELBOURNE, FL, 329013000, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 321-872-0723 |
| Fax | 3218720721 |
Authorized person
| Name | MARK SANGREE |
| Role | PRES |
| Phone | 3218720723 |
Taxonomy
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| License Number | 16452MS |
| State | ID |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| License Number | 5301008923 |
| State | MI |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| License Number | PH27532 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| License Number | FL1446 |
| State | KY |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| License Number | NRX1701137 |
| State | DC |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| License Number | A9-0001042 |
| State | DE |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| License Number | 3942 |
| State | IA |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| License Number | P03052 |
| State | MD |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| License Number | 64000903A |
| State | IN |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| License Number | 22-02899 |
| State | KS |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| License Number | PHNR 000556 |
| State | GA |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| License Number | 006292 |
| State | LA |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| License Number | 054.016601 |
| State | IL |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| License Number | PMP-1330 |
| State | HI |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1366416448 |
| State | MN |
| Issuer | MEDICAID |
| Number | 1366416448 |
| State | IL |
| Issuer | MEDICAID |
| Number | 226807 |
| State | NH |
| Issuer | MEDICAID |
| Number | 546330 |
| State | NJ |
| Issuer | MEDICAID |
| Number | 1000055714 |
| State | WI |
| Issuer | MEDICAID |
| Number | 1366416448 |
| State | ID |
| Issuer | MEDICAID |
| Number | 1366416448 |
| State | UT |
| Issuer | MEDICAID |
| Number | 2856995 |
| State | OH |
| Issuer | MEDICAID |
| Number | 02199910 |
| State | FL |
| Issuer | MEDICAID |
| Number | 134038 |
| State | AZ |
| Issuer | PK |
| Number | 2013120 |
| Issuer | MEDICAID |
| Number | 201352590A |
| State | IN |
| Issuer | MEDICAID |
| Number | 7100410000 |
| State | KY |
| Issuer | MEDICAID |
| Number | 10026562600 |
| State | NE |
| Issuer | MEDICAID |
| Number | 1028490 |
| State | VT |
| Issuer | MEDICAID |
| Number | 105780400 |
| State | MD |
| Issuer | MEDICAID |
| Number | 200647710A |
| State | OK |
| Issuer | MEDICAID |
| Number | 1366416448 |
| State | NM |
| Issuer | MEDICAID |
| Number | 2059467 |
| State | WA |
| Issuer | MEDICAID |
| Number | 500707688 |
| State | OR |
| Name | Role | Address |
|---|---|---|
| sangree mark L | President | 199 SW 15th Court, Boca Raton, FL, 33486 |
| SANGREE MARK LPres | Agent | 1515 ELIZABETH STREET, MELBOURNE, FL, 32901 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000094393 | AMEX WELLNESS | ACTIVE | 2023-08-13 | 2028-12-31 | - | 1515 ELIZABETH ST, STE K, MELBOURNE, FL, 32901 |
| G22000130747 | AMEXHEMP | ACTIVE | 2022-10-19 | 2027-12-31 | - | 1515 ELIZABETH STREET, SUITE K, MELBOURNE, FL, 32901 |
| G16000062364 | AMEX PHARMACY | ACTIVE | 2016-06-24 | 2026-12-31 | - | 1515 ELIZABETH ST., SUITE J, MELBOURNE, FL, 32901 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | - | - |
| REGISTERED AGENT NAME CHANGED | 2019-02-06 | SANGREE, MARK L, Pres | - |
| CHANGE OF MAILING ADDRESS | 2009-04-15 | 1515 ELIZABETH STREET, SUITE J, MELBOURNE, FL 32901 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2009-04-15 | 1515 ELIZABETH STREET, SUITE J, MELBOURNE, FL 32901 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2007-01-07 | 1515 ELIZABETH STREET, SUITE J, MELBOURNE, FL 32901 | - |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2023-09-06 |
| ANNUAL REPORT | 2023-05-15 |
| ANNUAL REPORT | 2022-03-17 |
| ANNUAL REPORT | 2021-04-07 |
| ANNUAL REPORT | 2020-05-12 |
| ANNUAL REPORT | 2019-02-06 |
| ANNUAL REPORT | 2018-04-18 |
| ANNUAL REPORT | 2017-02-10 |
| ANNUAL REPORT | 2016-02-02 |
| ANNUAL REPORT | 2015-03-09 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 4663127201 | 2020-04-27 | 0455 | PPP | 1515 ELIZABETH ST STE J, MELBOURNE, FL, 32901-3000 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 03 Apr 2025
Sources: Florida Department of State
