| Entity Name: | YOUR NEIGHBORHOOD PHARMACY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 24 Apr 2012 (13 years ago) |
| Date of dissolution: | 27 Sep 2013 (11 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2013 (11 years ago) |
| Document Number: | L12000054874 |
| Address: | 4481 LAKE WORTH ROAD, LAKE WORTH, FL 33461 |
| Mail Address: | 4481 LAKE WORTH ROAD, LAKE WORTH, FL 33461 |
| ZIP code: | 33461 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679712673 | 2009-02-13 | 2009-12-07 | 11067 SPRING HILL DR, SPRING HILL, FL, 346085000, US | 11067 SPRING HILL DR, SPRING HILL, FL, 346085000, US | |||||||||||||||||||||||
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| Phone | +1 352-666-4466 |
| Fax | 3526664467 |
Authorized person
| Name | SWETHA MADGULA |
| Role | PRESIDENT |
| Phone | 3526664466 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH23899 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 1043087 |
| Name | Role | Address |
|---|---|---|
| DISTEPHANO, JANET | Agent | 6128 SOUTH CONGRESS AVENUE, LAKE WORTH, FL 33462 |
| Name | Role | Address |
|---|---|---|
| DISTEPHANO, JANET | Managing Member | 107-40 QUEENS BLVD. APT. 16B, FOREST HILLS, NY 11375 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| LC AMENDMENT | 2012-05-31 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-05-31 | 4481 LAKE WORTH ROAD, LAKE WORTH, FL 33461 | No data |
| CHANGE OF MAILING ADDRESS | 2012-05-31 | 4481 LAKE WORTH ROAD, LAKE WORTH, FL 33461 | No data |
| Name | Date |
|---|---|
| LC Amendment | 2012-05-31 |
| Florida Limited Liability | 2012-04-24 |
Date of last update: 23 Jan 2025
Sources: Florida Department of State
