| Entity Name: | SIGNATURE PHARMACY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 01 Mar 2002 (23 years ago) |
| Date of dissolution: | 26 Sep 2014 (10 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (10 years ago) |
| Document Number: | P02000023291 |
| FEI/EIN Number | 043611848 |
| Address: | 2304 ALOMA AVENUE, WINTER PARK, FL, 32792 |
| Mail Address: | 5097 LATROBE DRIVE, WINDERMERE, FL, 34786 |
| ZIP code: | 32792 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1730100785 | 2006-07-22 | 2010-07-01 | 1200 KUHL AVE, ORLANDO, FL, 328061127, US | 1200 KUHL AVE, ORLANDO, FL, 328061127, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 407-426-9944 |
| Fax | 4074269923 |
Authorized person
| Name | NAOMI LOOMIS |
| Role | OWNER MANAGER |
| Phone | 4074479844 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH18497 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336M0002X - Mail Order Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 025722200 |
| State | FL |
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 1097713 |
| Name | Role | Address |
|---|---|---|
| STOVASH, CASE & TINGLEY, P.A. | Agent | 200 S. ORANGE AVENUE, ORLANDO, FL, 32801 |
| Name | Role | Address |
|---|---|---|
| LOOMIS NAOMI L | President | 5097 LATROBE DRIVE, WINDERMERE, FL, 34786 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2011-01-05 | 2304 ALOMA AVENUE, WINTER PARK, FL 32792 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-03-21 | 2304 ALOMA AVENUE, WINTER PARK, FL 32792 | No data |
| REGISTERED AGENT NAME CHANGED | 2007-02-01 | STOVASH, CASE & TINGLEY, P.A. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-02-01 | 200 S. ORANGE AVENUE, SUITE 1220, ORLANDO, FL 32801 | No data |
| AMENDMENT | 2006-08-04 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13000494352 | LAPSED | 1000000433785 | ORANGE | 2013-01-31 | 2023-02-27 | $ 332.38 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MAITLAND SERVICE CENTER, 2301 MAITLAND CENTER PKWY STE 160, MAITLAND FL327514192 |
| J12000608391 | ACTIVE | 1000000316650 | ORANGE | 2012-08-27 | 2032-09-19 | $ 330.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MAITLAND SERVICE CENTER, 2301 MAITLAND CENTER PKWY STE 160, MAITLAND FL327514192 |
| J11000034749 | LAPSED | 10-CC-8457 | ORANGE COUNTY | 2010-10-12 | 2016-01-19 | $13,938.44 | BELLSOUTH ADVERTISING & PUBLISHING CORP, 2247 NORTHLAKE PARKWAY, SUITE 3C, TUCKER, GA. 30084 |
| J10000732443 | ACTIVE | 1000000177574 | ORANGE | 2010-06-25 | 2030-07-07 | $ 18,635.61 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MAITLAND SERVICE CENTER, 2301 MAITLAND CENTER PKWY STE 160, MAITLAND FL327514192 |
| J09002195245 | LAPSED | 08-CA-9677 | ORANGE CIRCUIT COURT CIVIL DIV | 2009-09-21 | 2014-10-30 | $162,933.60 | PFIZER, INC., 575 UNDERHILL BLVD., SUITE 118, SYOSSET, NY 11791 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-01-24 |
| ANNUAL REPORT | 2012-01-06 |
| ANNUAL REPORT | 2011-01-05 |
| ANNUAL REPORT | 2010-01-25 |
| ANNUAL REPORT | 2009-01-21 |
| ANNUAL REPORT | 2008-03-21 |
| Reg. Agent Change | 2007-02-01 |
| ANNUAL REPORT | 2007-01-10 |
| Amendment | 2006-08-04 |
| ANNUAL REPORT | 2006-04-24 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
