| Entity Name: | KROGER SPECIALTY PHARMACY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 20 Jan 2000 (25 years ago) |
| Document Number: | P00000006220 |
| FEI/EIN Number | 593622808 |
| Address: | 1014 Vine Street, Cincinnati, OH, 45202, US |
| Mail Address: | 1014 Vine Street, ATTN: TAX DEPT GO 7, Cincinnati, OH, 45202, US |
| Place of Formation: | FLORIDA |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | KROGER SPECIALTY PHARMACY, INC., ALASKA | 10010644 | ALASKA |
| Headquarter of | KROGER SPECIALTY PHARMACY, INC., ALABAMA | 000-533-770 | ALABAMA |
| Headquarter of | KROGER SPECIALTY PHARMACY, INC., NEW YORK | 3149290 | NEW YORK |
| Headquarter of | KROGER SPECIALTY PHARMACY, INC., ILLINOIS | CORP_69113664 | ILLINOIS |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1598765570 | 2005-07-29 | 2020-09-30 | 3200 LAKE EMMA RD UNIT 1000, LAKE MARY, FL, 327463358, US | 3200 LAKE EMMA RD UNIT 1000, LAKE MARY, FL, 327463358, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 855-733-3126 |
| Fax | 8883153270 |
Authorized person
| Name | DEBRA J COLE |
| Role | VICE PRESIDENT |
| Phone | 8557333126 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | PH17230 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336S0011X - Specialty Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 100246590A |
| State | OK |
| Issuer | MEDICAID |
| Number | 1010381 |
| State | VT |
| Issuer | MEDICAID |
| Number | 1531290 |
| State | TN |
| Issuer | MEDICAID |
| Number | 1598765570 |
| State | MN |
| Issuer | MEDICAID |
| Number | 3087712 |
| State | NH |
| Issuer | MEDICAID |
| Number | 33321884 |
| State | CO |
| Issuer | MEDICAID |
| Number | 500628537 |
| State | OR |
| Issuer | MEDICAID |
| Number | 7038923 |
| State | MT |
| Issuer | MEDICAID |
| Number | 1044873 |
| State | WA |
| Issuer | MEDICAID |
| Number | 7100166410 |
| State | KY |
| Issuer | MEDICAID |
| Number | 7F7230 |
| State | SC |
| Issuer | MEDICAID |
| Number | 008003029 |
| State | CT |
| Issuer | MEDICAID |
| Number | 1598765570 |
| State | CA |
| Issuer | MEDICAID |
| Number | 582023 |
| State | TX |
| Issuer | MEDICAID |
| Number | 9094202 |
| State | NJ |
| Issuer | MEDICAID |
| Number | 0018492980003 |
| State | PA |
| Issuer | MEDICAID |
| Number | 003119890 |
| State | CT |
| Issuer | MEDICAID |
| Number | 0541920 |
| State | IA |
| Issuer | MEDICAID |
| Number | 1451031 |
| State | ND |
| Issuer | MEDICAID |
| Number | 1598765570 |
| State | ME |
| Issuer | MEDICAID |
| Number | 1598765570 |
| State | MI |
| Issuer | MEDICAID |
| Number | 2207678 |
| State | OH |
| Issuer | MEDICAID |
| Number | 416817800 |
| State | MD |
| Issuer | MEDICAID |
| Number | 0022363802 |
| State | FL |
| Issuer | MEDICAID |
| Number | 022363800 |
| State | FL |
| Issuer | MEDICAID |
| Number | 0270686 |
| State | MT |
| Issuer | MEDICAID |
| Number | 03105699 |
| State | NY |
| Issuer | MEDICAID |
| Number | 1028738 |
| State | AK |
| Issuer | MEDICAID |
| Number | 1598765570 |
| State | ID |
| Issuer | MEDICAID |
| Number | 1598765570 |
| State | NC |
| Issuer | MEDICAID |
| Number | 057055900 |
| State | DC |
| Issuer | MEDICAID |
| Number | 200297170A |
| State | IN |
| Issuer | MEDICAID |
| Number | 500626260 |
| State | OR |
| Issuer | MEDICAID |
| Number | 094403300 |
| State | MD |
| Issuer | MEDICAID |
| Number | 100246590B |
| State | OK |
| Issuer | MEDICAID |
| Number | 100444750A |
| State | KS |
| Issuer | MEDICAID |
| Number | 115772800 |
| State | WY |
| Issuer | MEDICAID |
| Number | 1598765570 |
| State | VA |
| Issuer | MEDICAID |
| Number | 536089 |
| State | AZ |
| Issuer | MEDICAID |
| Number | 1598765570 |
| State | NV |
| Issuer | MEDICAID |
| Number | DM1317 |
| State | SC |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| Carin Fike L | Vice President | 1014 VINE STREET, CINCINNATI, OH, 452021100 |
| Shelly Tom L | Vice President | 3200 Lake Emma Road, LAKE MARY, FL, 32746 |
| Name | Role | Address |
|---|---|---|
| ROBERTS DOROTHY D | Asst | 1014 VINE STREET, CINCINNATI, OH, 452021100 |
| BRADLEY JOSEPH W | Asst | 1014 VINE STREET, CINCINNATI, OH, 452021100 |
| Name | Role | Address |
|---|---|---|
| Lindholz Colleen | President | 3200 Lake Emma Road, LAKE MARY, FL, 32746 |
| Name | Role | Address |
|---|---|---|
| WHEATLEY CHRISTINE S | Director | 1014 VINE STREET, CINCINNATI, OH, 45202 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000099044 | KROGER SPECIALTY PHARMACY FL | ACTIVE | 2017-08-30 | 2027-12-31 | No data | C/O KROGER/ROUNDY'S LAW DEPT. MS-2600, 875 EAST WISCONSIN AVENUE, MILWAUKEE, WI, 53202 |
| G12000006666 | AXIS PHARMACEUTICAL PARTNERS | EXPIRED | 2012-01-19 | 2017-12-31 | No data | 550 TECHNOLOGY PARK, LAKE MARY, FL, 32746 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDED AND RESTATEDARTICLES/NAME CHANGE | 2024-10-04 | BIOPLUS SPECIALTY PHARMACY, INC. | No data |
| AMENDMENT AND NAME CHANGE | 2016-10-04 | KROGER SPECIALTY PHARMACY, INC. | No data |
| MERGER | 2006-09-12 | No data | CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 300000059383 |
| AMENDED AND RESTATEDARTICLES | 2005-11-02 | No data | No data |
| MERGER | 2003-06-06 | No data | CORPORATION WAS A MERGER RESULT. TOTAL NUMBER OF QUALIFIED CORPORATION(S) INVOLVED WAS 1. MERGER NUMBER 500000045345 |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
