| Entity Name: | MGC PHARMACY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 25 Jul 2007 (18 years ago) |
| Date of dissolution: | 27 Apr 2015 (10 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 27 Apr 2015 (10 years ago) |
| Document Number: | L07000076931 |
| FEI/EIN Number | 26-0590687 |
| Address: | 1516 EAST 4TH AVE., HIALEAH, FL 33010 |
| Mail Address: | 1516 EAST 4TH AVE., HIALEAH, FL 33010 |
| ZIP code: | 33010 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1255613899 | 2011-09-09 | 2011-09-09 | 1516 E 4TH AVE, HIALEAH, FL, 330103159, US | 1516 E 4TH AVE, HIALEAH, FL, 330103159, US | |||||||||||||||||||||||
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| Phone | +1 305-884-7455 |
| Fax | 3058847454 |
Authorized person
| Name | LUIS ALFONSO |
| Role | CLINICAL PHARMACY DIRECTOR |
| Phone | 3058847455 |
Taxonomy
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| License Number | PH25619 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 5707370 |
| Name | Role | Address |
|---|---|---|
| ALFONSO, LUIS MGR | Agent | 1516 EAST 4TH AVE, HIALEAH, FL 33010 |
| Name | Role | Address |
|---|---|---|
| ALFONSO, LUIS | Manager | 1516 EAST 4TH AVE., HIALEAH, FL 33010 |
| GONZALEZ, MELVIN | Manager | 1516 EAST 4TH AVE., HIALEAH, FL 33010 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G08092900015 | MGC HEALTH MART PHARMACY | EXPIRED | 2008-04-01 | 2013-12-31 | No data | 1516 EAST 4TH AVENUE, HIALEAH, FL, 33010 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2015-04-27 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2010-01-15 | ALFONSO, LUIS MGR | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-01-15 | 1516 EAST 4TH AVE, HIALEAH, FL 33010 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2015-04-27 |
| ANNUAL REPORT | 2014-02-13 |
| ANNUAL REPORT | 2013-02-13 |
| ANNUAL REPORT | 2012-01-26 |
| ANNUAL REPORT | 2011-01-04 |
| ANNUAL REPORT | 2010-01-15 |
| ANNUAL REPORT | 2009-04-15 |
| ANNUAL REPORT | 2008-03-11 |
| Florida Limited Liability | 2007-07-25 |
Date of last update: 27 Jan 2025
Sources: Florida Department of State
