| Entity Name: | NICANOR PHARMACY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 11 Oct 1977 (47 years ago) |
| Document Number: | 554088 |
| FEI/EIN Number | 591779451 |
| Address: | 1003 WEST FLAGLER ST, MIAMI, FL, 33130-1031 |
| Mail Address: | 1003 WEST FLAGLER ST, MIAMI, FL, 33130-1031 |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1720177132 | 2006-10-12 | 2008-06-23 | 1003 W FLAGLER ST, MIAMI, FL, 331301031, US | 1003 W FLAGLER ST, MIAMI, FL, 331301031, US | |||||||||||||||||||||||||
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| Phone | +1 305-324-5020 |
| Fax | 3053244333 |
Authorized person
| Name | MR. JOSE MANUEL TEIJEIRO |
| Role | PRESIDENT |
| Phone | 3053245020 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | PH6878 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 032462100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| TEIJEIRO JOSE | Agent | 1003 W FLAGLER STREET, MIAMI, FL, 33130 |
| Name | Role | Address |
|---|---|---|
| PARGA ANGEL | President | 1003 W FLAGLER ST, MIAMI, FL, 33130 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2011-09-23 | No data | No data |
| AMENDMENT | 2009-09-22 | No data | No data |
| AMENDMENT | 2008-02-26 | No data | No data |
Date of last update: 03 Jan 2025
Sources: Florida Department of State
