| Entity Name: | WAKULLA STATION PHARMACY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 03 Oct 2003 (21 years ago) |
| Date of dissolution: | 25 Sep 2009 (15 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 25 Sep 2009 (15 years ago) |
| Document Number: | P03000108725 |
| FEI/EIN Number | 200283033 |
| Address: | 961 WOODVILLE HIGHWAY, CRAWFORDVILLE, FL, 32327 |
| Mail Address: | 961 WOODVILLE HIGHWAY, CRAWFORDVILLE, FL, 32327 |
| ZIP code: | 32327 |
| County: | Wakulla |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629112818 | 2007-02-19 | 2008-06-26 | 961 WOODVILLE HWY, CRAWFORDVILLE, FL, 323270706, US | 961 WOODVILLE HWY, CRAWFORDVILLE, FL, 323270706, US | |||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||
| Phone | +1 850-421-4040 |
| Fax | 8504214020 |
Authorized person
| Name | RITA HUGHES ABARBANEL |
| Role | OWNER |
| Phone | 8504214040 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH21189 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 028236700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ABARBANEL RITA | Agent | 3524 TRILLIUM CT, TALLAHASSEE, FL, 32312 |
| Name | Role | Address |
|---|---|---|
| ABARBANEL RITA | President | 3524 TRILLIUM CT, TALLAHASSEE, FL, 32312 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| CANCEL ADM DISS/REV | 2007-10-05 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2007-09-14 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2005-06-20 | 961 WOODVILLE HIGHWAY, CRAWFORDVILLE, FL 32327 | No data |
| CHANGE OF MAILING ADDRESS | 2005-06-20 | 961 WOODVILLE HIGHWAY, CRAWFORDVILLE, FL 32327 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2008-04-03 |
| REINSTATEMENT | 2007-10-05 |
| ANNUAL REPORT | 2006-03-06 |
| ANNUAL REPORT | 2005-06-20 |
| ANNUAL REPORT | 2004-03-10 |
| Domestic Profit | 2003-10-03 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
