| Entity Name: | ORLANDO PHARMACY INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 17 Mar 1965 (60 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 25 Oct 2016 (8 years ago) |
| Document Number: | 290983 |
| FEI/EIN Number | 59-1095101 |
| Address: | 2909 NORTH ORANGE AVENUE, SUITE # 112, ORLANDO, FL 32804 |
| Mail Address: | 2909 NORTH ORANGE AVENUE, SUITE # 112, ORLANDO, FL 32804 |
| ZIP code: | 32804 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | ORLANDO PHARMACY INC, ILLINOIS | CORP_71533921 | ILLINOIS |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1124114210 | 2006-10-05 | 2020-06-22 | 2909 N ORANGE AVE STE 112, ORLANDO, FL, 328044639, US | 2909 N ORANGE AVE STE 112, ORLANDO, FL, 328044639, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 407-898-1331 |
| Fax | 4078951672 |
Authorized person
| Name | CRAIG SICINSKI |
| Role | PRESIDENT |
| Phone | 4078981331 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | OSP.0007037 |
| State | CO |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH1118 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 17621 |
| State | SC |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 31512 |
| State | TX |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 0214001950 |
| State | VA |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 054020722 |
| State | IL |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PHNR001312 |
| State | GA |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 022816000-02 |
| State | OH |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 2017033917 |
| State | MO |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 10518152-1708 |
| State | UT |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | Y007432 |
| State | AZ |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2007523 |
| Issuer | MEDICAID |
| Number | 100689400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MUSCA, DANIEL G | Agent | 13139 WEST LINEBAUGH AVENUE, SUITE 101, TAMPA, FL 33626 |
| Name | Role | Address |
|---|---|---|
| SICINSKI, CRAIG | President | 1614 SUMTER LANE, WEST MELBOURNE, FL 32904 |
| Name | Role | Address |
|---|---|---|
| SICINSKI, CRAIG | Secretary | 1614 SUMTER LANE, WEST MELBOURNE, FL 32904 |
| Name | Role | Address |
|---|---|---|
| SICINSKI, CRAIG | Treasurer | 1614 SUMTER LANE, WEST MELBOURNE, FL 32904 |
| Name | Role | Address |
|---|---|---|
| SICINSKI, CRAIG | Director | 1614 SUMTER LANE, WEST MELBOURNE, FL 32904 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2016-10-25 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-10-25 | MUSCA, DANIEL G | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-10-25 | 13139 WEST LINEBAUGH AVENUE, SUITE 101, TAMPA, FL 33626 | No data |
| AMENDMENT | 2016-08-15 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-01-05 | 2909 NORTH ORANGE AVENUE, SUITE # 112, ORLANDO, FL 32804 | No data |
| CHANGE OF MAILING ADDRESS | 2010-01-05 | 2909 NORTH ORANGE AVENUE, SUITE # 112, ORLANDO, FL 32804 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-25 |
| ANNUAL REPORT | 2024-01-20 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-01-23 |
| ANNUAL REPORT | 2021-01-09 |
| ANNUAL REPORT | 2020-01-13 |
| ANNUAL REPORT | 2019-01-18 |
| ANNUAL REPORT | 2018-01-14 |
| ANNUAL REPORT | 2017-01-10 |
| Amendment | 2016-10-25 |
Date of last update: 06 Feb 2025
Sources: Florida Department of State
