| Entity Name: | NORTHWEST MEDICAL PHARMACY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
NORTHWEST MEDICAL PHARMACY LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 11 Feb 2009 (16 years ago) |
| Date of dissolution: | 23 Sep 2016 (9 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (9 years ago) |
| Document Number: | L09000014134 |
| FEI/EIN Number |
383890017
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 27391 S Dixie Hwy, Naranja, FL, 33032, US |
| Mail Address: | 27391 S Dixie Hwy, Naranja, FL, 33032, US |
| ZIP code: | 33032 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1083901938 | 2011-06-29 | 2013-02-14 | 2089 SW 67TH AVE, SUITE B, MIAMI, FL, 331551835, US | 2089 SW 67TH AVE, SUITE B, MIAMI, FL, 331551835, US | |||||||||||||||||||||||||||||
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| Phone | +1 305-637-6776 |
| Fax | 3056373404 |
Authorized person
| Name | ALEXEI TOLEDO |
| Role | MGRM |
| Phone | 3056376776 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | PH25535 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 004301400 |
| State | FL |
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 5706392 |
| Name | Role | Address |
|---|---|---|
| CANCIO RAFAEL | Managing Member | 2089 SW 67 AVE, MIAMI, FL, 33155 |
| CANCIO RAFAEL | Agent | 2089 SW LUDLAM ROAD SUITE B, MIAMI, FL, 33155 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000004357 | SOUTHWEST RETAIL PHARMACY | EXPIRED | 2015-01-12 | 2020-12-31 | - | 27391 S DIXIE HWY, NARANJA, FL, 33032 |
| G10000111787 | NMB PHARMACY | EXPIRED | 2010-12-08 | 2015-12-31 | - | 693 N.E. 167 STREET, NORTH MIAMI BEACH, FL, 33162 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2015-01-14 | 27391 S Dixie Hwy, Naranja, FL 33032 | - |
| CHANGE OF MAILING ADDRESS | 2015-01-14 | 27391 S Dixie Hwy, Naranja, FL 33032 | - |
| REGISTERED AGENT NAME CHANGED | 2014-05-15 | CANCIO, RAFAEL | - |
| LC AMENDMENT | 2014-05-15 | - | - |
| LC AMENDMENT | 2014-05-07 | - | - |
| LC AMENDMENT | 2013-08-01 | - | - |
| REGISTERED AGENT ADDRESS CHANGED | 2013-07-30 | 2089 SW LUDLAM ROAD SUITE B, MIAMI, FL 33155 | - |
| LC AMENDMENT | 2013-07-30 | - | - |
| LC AMENDMENT | 2012-11-09 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2015-01-14 |
| LC Amendment | 2014-05-15 |
| LC Amendment | 2014-05-07 |
| ANNUAL REPORT | 2014-03-18 |
| LC Amendment | 2013-08-01 |
| LC Amendment | 2013-07-30 |
| ANNUAL REPORT | 2013-03-14 |
| LC Amendment | 2012-11-09 |
| ANNUAL REPORT | 2012-07-02 |
| ANNUAL REPORT | 2012-04-04 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
