| Entity Name: | SANTA ROSA PHARMACY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 15 May 2003 (22 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | P03000056785 |
| FEI/EIN Number | 56-2363202 |
| Mail Address: | 53 ALBATROSS COURT, SANTA ROSA BEACH, FL 32459 |
| Address: | 19 TOWN CENTER LOOP, 1-A, SANTA ROSA BEACH, FL 32459 |
| ZIP code: | 32459 |
| County: | Walton |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154426070 | 2006-09-14 | 2007-11-16 | 19 TOWN CENTER LOOP, UNIT 1A, SANTA ROSA BEACH, FL, 32459, US | 19 TOWN CENTER LOOP, UNIT 1A, SANTA ROSA BEACH, FL, 32459, US | |||||||||||||||||||||||||
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| Phone | +1 850-622-3313 |
| Fax | 8506223255 |
Authorized person
| Name | MR. GEORGE THOMAS FLOWERS |
| Role | PRES. |
| Phone | 8506223313 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH19512 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NCPDP |
| Number | 1001180 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| FLOWERS, GEORGE T | Agent | 53 ALBATROSS CT, SANTA ROSA BEACH, FL 32459 |
| Name | Role | Address |
|---|---|---|
| FLOWERS, GEORGE T | President | 53 ALBATROSS CT, SANTA ROSA BEACH, FL 32459 |
| Name | Role | Address |
|---|---|---|
| FLOWERS, TAMI L | Secretary | 53 ALBATROSS CT, SANTA ROSA BEACH, FL 32459 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2011-04-30 | 19 TOWN CENTER LOOP, 1-A, SANTA ROSA BEACH, FL 32459 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2008-04-30 | 19 TOWN CENTER LOOP, 1-A, SANTA ROSA BEACH, FL 32459 | No data |
| CANCEL ADM DISS/REV | 2007-04-30 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-04-30 | 53 ALBATROSS CT, SANTA ROSA BEACH, FL 32459 | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-04-30 |
| ANNUAL REPORT | 2010-04-30 |
| ANNUAL REPORT | 2009-06-26 |
| ANNUAL REPORT | 2008-04-30 |
| REINSTATEMENT | 2007-04-30 |
| ANNUAL REPORT | 2005-04-29 |
| ANNUAL REPORT | 2004-04-26 |
| Domestic Profit | 2003-05-15 |
Date of last update: 30 Jan 2025
Sources: Florida Department of State
