| Entity Name: | MELROSE PHARMACY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 12 Oct 2000 (24 years ago) |
| Date of dissolution: | 14 Sep 2007 (17 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 14 Sep 2007 (17 years ago) |
| Document Number: | P00000096185 |
| FEI/EIN Number | 593678492 |
| Address: | 8744 S.R. 21, MELROSE, FL, 32666 |
| Mail Address: | 8744 S.R. 21, MELROSE, FL, 32666 |
| ZIP code: | 32666 |
| County: | Putnam |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1649277641 | 2005-07-05 | 2020-08-22 | 8744 STATE ROAD 21, MELROSE, FL, 326668809, US | 8744 STATE ROAD 21, MELROSE, FL, 326668809, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 352-475-3919 |
| Fax | 3524751467 |
Authorized person
| Name | HOWARD W ECKENRODE |
| Role | PHARMACIST/OWNER |
| Phone | 3524753919 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | BM7562172 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | BM7562172 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | BCBS PROVIDER # |
| Number | R9537 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ECKENRODE HOWARD | Agent | 216 NE 6TH ST, GAINESVILLE, FL, 32601 |
| Name | Role | Address |
|---|---|---|
| ECKENRODE HOWARD | President | 216 NE 6TH STREET, GAINESVILLE, FL, 326015574 |
| Name | Role | Address |
|---|---|---|
| ECKENRODE HOWARD | Treasurer | 216 NE 6TH STREET, GAINESVILLE, FL, 326015574 |
| Name | Role | Address |
|---|---|---|
| ECKENRODE JENNY | Vice President | 216 NE 6TH STREET, GAINESVILLE, FL, 326015574 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2001-10-24 | 8744 S.R. 21, MELROSE, FL 32666 | No data |
| CHANGE OF MAILING ADDRESS | 2001-10-24 | 8744 S.R. 21, MELROSE, FL 32666 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2006-05-08 |
| ANNUAL REPORT | 2005-05-05 |
| ANNUAL REPORT | 2004-04-07 |
| ANNUAL REPORT | 2003-08-29 |
| ANNUAL REPORT | 2002-08-29 |
| ANNUAL REPORT | 2001-10-24 |
| Domestic Profit | 2000-10-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
