| Entity Name: | WEISE PRESCRIPTION SHOP, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 22 Aug 1969 (55 years ago) |
| Document Number: | 351175 |
| FEI/EIN Number | 591269400 |
| Address: | 4343 COLONIAL AVE, JACKSONVILLE, FL, 32210 |
| Mail Address: | 4343 COLONIAL AVE, JACKSONVILLE, FL, 32210 |
| ZIP code: | 32210 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710052063 | 2006-11-22 | 2020-08-22 | 4343 COLONIAL AVENUE, JACKSONVILLE, FL, 322103393, US | 4343 COLONIAL AVENUE, JACKSONVILLE, FL, 322103393, US | |||||||||||||||||||||||
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| Phone | +1 904-388-1564 |
| Fax | 9043840569 |
Authorized person
| Name | MR. GILBERT NELSON WEISE JR. |
| Role | PHARMACIST MANAGER |
| Phone | 9043881564 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | PH520 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NABP |
| Number | 1012234 |
| Name | Role |
|---|---|
| FT CORPORATE SERVICES, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| WEISE JO H | President | 8601 EMERALD ISLE CIR.N., JACKSONVILLE, FL, 32216 |
| Name | Role | Address |
|---|---|---|
| WEISE GILBERT N | Director | 1733 SANCTUARY WAY, FLEMING ISLAND, FL, 32003 |
| WEISE JUSTIN | Director | 44 EAST 5TH ST, JACKSONVILLE, FL, 32206 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000107104 | WEISE GILBERT NELSON | EXPIRED | 2013-10-31 | 2018-12-31 | No data | 4343 COLONIAL AVE, JACKSONVILLE, FL, 32210 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
