| Entity Name: | PUMAR PHARMACY INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 28 Sep 1984 (40 years ago) |
| Document Number: | M05780 |
| FEI/EIN Number | 592528454 |
| Address: | 390 SW 109 AVE., MIAMI, FL, 33174, US |
| Mail Address: | 390 SW 109 AVE., MIAMI, FL, 33174, US |
| ZIP code: | 33174 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194863944 | 2007-02-02 | 2009-08-13 | 528 SW 109TH AVE, MIAMI, FL, 331741336, US | 528 SW 109TH AVE, MIAMI, FL, 331741336, US | |||||||||||||||||||||||||||||
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| Phone | +1 305-552-0166 |
| Fax | 3055520168 |
Authorized person
| Name | ALEX FRANK NEGRIN |
| Role | VICE PRESIDENT |
| Phone | 3055514177 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH8965 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | OTHER ID NUMBER |
| Number | 1022007 |
| Issuer | MEDICAID |
| Number | 101518400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| NEGRIN ALEX F | Agent | 300 SW 107 AVE., MIAMI, FL, 33174 |
| Name | Role | Address |
|---|---|---|
| NEGRIN JOSE M | President | 13201 SW 2 STREET, MIAMI, FL, 33184 |
| Name | Role | Address |
|---|---|---|
| NEGRIN BERTA | Secretary | 13201 SW 2 STREET, MIAMI, FL, 33184 |
| Name | Role | Address |
|---|---|---|
| NEGRIN BERTA | Director | 13201 SW 2 STREET, MIAMI, FL, 33184 |
| NEGRIN ALEX F | Director | 12990 SW 2 STREET, MIAMI, FL, 33184 |
| Name | Role | Address |
|---|---|---|
| NEGRIN ALEX F | Treasurer | 12990 SW 2 STREET, MIAMI, FL, 33184 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G15000040772 | SWEETWATER PHARMACY | EXPIRED | 2015-04-23 | 2020-12-31 | No data | 528 SW 109 AVE, MIAMI, FL, 33174 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| REINSTATEMENT | 2020-10-10 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2020-09-25 | No data | No data |
| AMENDMENT | 2007-11-16 | No data | No data |
| REINSTATEMENT | 1990-07-10 | No data | No data |
| INVOLUNTARILY DISSOLVED | 1989-10-13 | No data | No data |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
