| Entity Name: | WELLNESS PHARMACY OF ST. AUGUSTINE LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 27 Feb 2013 (12 years ago) |
| Date of dissolution: | 30 Mar 2018 (7 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 30 Mar 2018 (7 years ago) |
| Document Number: | L13000030666 |
| FEI/EIN Number | 46-2141397 |
| Address: | 4405 SARTILLO RD, SUITE C, ST. AUGUSTINE, FL, 32095 |
| Mail Address: | 4405 SARTILLO RD, SUITE C, ST. AUGUSTINE, FL, 32095, US |
| ZIP code: | 32095 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1902202898 | 2014-11-05 | 2014-11-05 | 4405 SARTILLO RD, SUITE B, ST AUGUSTINE, FL, 320955240, US | 4405 SARTILLO RD, SUITE B, ST AUGUSTINE, FL, 320955240, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 904-429-7333 |
| Fax | 9044602695 |
Authorized person
| Name | DINO AJLONI |
| Role | PHARMACIST |
| Phone | 9044297333 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH26918 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009136100 |
| State | FL |
| Issuer | NABP |
| Number | 5715252 |
| Issuer | FLORIDA BOARD OF PHARMACY LICENSE NUMBER |
| Number | PH26918 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| AJLONI SAM | Agent | 4405 SARTILLO RD, ST. AUGUSTINE, FL, 32095 |
| Name | Role | Address |
|---|---|---|
| AJLONI SAM | Managing Member | 4405 SARTILLO RD, SUITE C, ST. AUGUSTINE, FL, 32095 |
| Ajloni Amine | Managing Member | 4405 SARTILLO RD, ST. AUGUSTINE, FL, 32095 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G13000020886 | WELLNESS PHARMACY OF ST. AUGUSTINE | EXPIRED | 2013-02-28 | 2018-12-31 | No data | P.O. BOX 4128, ST AUGUSTINE, FL, 32085 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2018-03-30 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2017-01-14 | 4405 SARTILLO RD, SUITE C, ST. AUGUSTINE, FL 32095 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2018-03-30 |
| ANNUAL REPORT | 2017-01-14 |
| ANNUAL REPORT | 2016-03-10 |
| AMENDED ANNUAL REPORT | 2015-03-04 |
| ANNUAL REPORT | 2015-02-25 |
| ANNUAL REPORT | 2014-01-11 |
| Florida Limited Liability | 2013-02-27 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
