| Entity Name: | MOULTON'S PHARMACY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 24 Jun 2002 (23 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 23 May 2005 (20 years ago) |
| Document Number: | P02000069957 |
| FEI/EIN Number | 300090155 |
| Address: | 2798 Dogwood Acres, CRESTVIEW, FL, 32536-9368, US |
| Mail Address: | 2798 Dogwood Acres, CRESTVIEW, FL, 32536-9368, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780789941 | 2006-09-13 | 2020-08-22 | 648 N FERDON BLVD, CRESTVIEW, FL, 325362165, US | 648 N FERDON BLVD, CRESTVIEW, FL, 325362165, US | |||||||||||||||||||||||||
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| Phone | +1 850-682-6136 |
| Fax | 8506826185 |
Authorized person
| Name | RICHARD CURTIS MOULTON |
| Role | PRESIDENT |
| Phone | 8506826136 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH5000 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NABP |
| Number | 1024568 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MOULTON RICHARD C | Agent | 2798 Dogwood Acres, CRESTVIEW, FL, 325369368 |
| Name | Role | Address |
|---|---|---|
| MOULTON RICHARD C | President | 2798 Dogwood Acres, CRESTVIEW, FL, 325369368 |
| Name | Role | Address |
|---|---|---|
| MOULTON GLORIA M | Vice President | 2798 Dogwood Acres, CRESTVIEW, FL, 325369368 |
| Name | Role | Address |
|---|---|---|
| MOULTON GLORIA M | Secretary | 2798 Dogwood Acres, CRESTVIEW, FL, 325369368 |
| Name | Role | Address |
|---|---|---|
| MOULTON GLORIA M | Treasurer | 2798 Dogwood Acres, CRESTVIEW, FL, 325369368 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2018-02-20 | 2798 Dogwood Acres, CRESTVIEW, FL 32536-9368 | No data |
| CHANGE OF MAILING ADDRESS | 2018-02-20 | 2798 Dogwood Acres, CRESTVIEW, FL 32536-9368 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2018-02-20 | 2798 Dogwood Acres, CRESTVIEW, FL 32536-9368 | No data |
| AMENDMENT | 2005-05-23 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-02-05 |
| ANNUAL REPORT | 2022-03-30 |
| ANNUAL REPORT | 2021-02-17 |
| ANNUAL REPORT | 2020-04-02 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-02-20 |
| ANNUAL REPORT | 2017-04-20 |
| ANNUAL REPORT | 2016-02-18 |
| ANNUAL REPORT | 2015-02-19 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
