| Entity Name: | HIGHLAND PHARMACY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 22 Dec 1989 (35 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 31 Jan 2022 (3 years ago) |
| Document Number: | L39238 |
| FEI/EIN Number | 59-2989627 |
| Address: | 4642 43RD PLACE NORTH, ST. PETERSBURG, FL 33714 |
| Mail Address: | 4642 43RD PLACE NORTH, ST. PETERSBURG, FL 33714 |
| ZIP code: | 33714 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427155266 | 2006-09-20 | 2022-03-02 | 1224 S HIGHLAND AVE, CLEARWATER, FL, 337564375, US | 1224 S HIGHLAND AVE, CLEARWATER, FL, 337564375, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 727-446-2331 |
| Fax | 7274469400 |
Authorized person
| Name | TRINH NGUYEN |
| Role | CEO |
| Phone | 7277353334 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH11168 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 101552400 |
| State | FL |
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 1062859 |
| Name | Role | Address |
|---|---|---|
| NGUYEN, THANH | Agent | 1224 SOUTH HIGHLAND AVENUE, CLEARWATER, FL 33756 |
| Name | Role | Address |
|---|---|---|
| NGUYEN, CONG | President | 4642 43RD PLACE NORTH, ST. PETERSBURG, FL 33714 |
| Name | Role | Address |
|---|---|---|
| NGUYEN, CONG | Chief Financial Officer | 4642 43RD PLACE NORTH, ST. PETERSBURG, FL 33714 |
| Name | Role | Address |
|---|---|---|
| NGUYEN, TRINH | Chief Executive Officer | 4642 43RD PLACE NORTH, ST. PETERSBURG, FL 33714 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-02-06 | 1224 SOUTH HIGHLAND AVENUE, CLEARWATER, FL 33756 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-01-31 | 4642 43RD PLACE NORTH, ST. PETERSBURG, FL 33714 | No data |
| AMENDMENT | 2022-01-31 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2022-01-31 | 4642 43RD PLACE NORTH, ST. PETERSBURG, FL 33714 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-01-31 | NGUYEN, THANH | No data |
| AMENDMENT | 2014-01-14 | No data | No data |
| REINSTATEMENT | 2014-01-14 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J02000453393 | LAPSED | 01-8713-CO-41 | PINELLAS / COUNTY COURT | 2002-10-07 | 2007-11-15 | $17,868.31 | FINOVA CAPITAL CORPORATION, 115 WEST CENTURY ROAD, PARAMUS, NJ 07652 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-06 |
| ANNUAL REPORT | 2023-04-16 |
| ANNUAL REPORT | 2022-04-19 |
| Amendment | 2022-01-31 |
| ANNUAL REPORT | 2021-02-24 |
| ANNUAL REPORT | 2020-04-09 |
| ANNUAL REPORT | 2019-02-13 |
| ANNUAL REPORT | 2018-04-18 |
| ANNUAL REPORT | 2017-01-18 |
| ANNUAL REPORT | 2016-02-05 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
