| Entity Name: | ELSA PHARMACY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 13 Mar 1979 (46 years ago) |
| Document Number: | 612657 |
| FEI/EIN Number | 591893638 |
| Address: | 1802 EAST 4 AVENUE, HIALEAH, FL, 33010, US |
| Mail Address: | 1802 EAST 4 AVENUE, HIALEAH, FL, 33010, US |
| ZIP code: | 33010 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639243074 | 2006-11-18 | 2018-07-19 | 1980 E 4TH AVE, HIALEAH, FL, 330102714, US | 1980 E 4TH AVE, HIALEAH, FL, 330102714, US | |||||||||||||||||||||||||||||||
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| Phone | +1 305-691-1968 |
| Fax | 3058362772 |
Authorized person
| Name | ELSA SOLER |
| Role | PRESIDENT |
| Phone | 3056911969 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH416 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | PK |
| Number | 2127909 |
| Name | Role | Address |
|---|---|---|
| CASALDUC GISELLE | Agent | 1802 EAST 4 AVENUE, HIALEAH, FL, 33010 |
| Name | Role | Address |
|---|---|---|
| MARTIN JULIO J | President | 1802 EAST 4 AVENUE, HIALEAH, FL, 33010 |
| Name | Role | Address |
|---|---|---|
| CASALDUC GISELLE | Vice President | 1802 EAST 4 AVENUE, HIALEAH, FL, 33010 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2010-07-07 | No data | No data |
| AMENDMENT | 2010-03-09 | No data | No data |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
