| Entity Name: | CRJ PHARMACY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 25 Jul 2005 (20 years ago) |
| Date of dissolution: | 26 Sep 2008 (16 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2008 (16 years ago) |
| Document Number: | P05000103747 |
| FEI/EIN Number | 203243677 |
| Address: | 1845 CRYSTAL LAKE DR, LAKELAND, FL, 33801, US |
| Mail Address: | 114 PALMOLA ST, LAKELAND, FL, 33813, US |
| ZIP code: | 33801 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942375670 | 2006-11-21 | 2020-08-22 | 1845 N CRYSTAL LAKE DR, LAKELAND, FL, 338015902, US | 1845 N CRYSTAL LAKE DR, LAKELAND, FL, 338015902, US | |||||||||||||||||||
|
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| Phone | +1 863-669-1329 |
| Fax | 8636691521 |
Authorized person
| Name | MR. DEREK ORVILLE O'BANNON |
| Role | PRESIDENT |
| Phone | 8636691329 |
Taxonomy
| Taxonomy Code | 302R00000X - Health Maintenance Organization |
| License Number | PH21511 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| MUCHEL JOSEPH | Agent | 6767 HILLIS DR., LAKELAND, FL, 33813 |
| Name | Role | Address |
|---|---|---|
| MUNCHEL JOSEPH | President | 6767 HILLIS DR., LAKELAND, FL, 33813 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2008-09-26 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2007-05-24 | MUCHEL, JOSEPH | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2007-05-24 | 6767 HILLIS DR., LAKELAND, FL 33813 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2006-03-13 | 1845 CRYSTAL LAKE DR, LAKELAND, FL 33801 | No data |
| CHANGE OF MAILING ADDRESS | 2006-03-13 | 1845 CRYSTAL LAKE DR, LAKELAND, FL 33801 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2007-05-24 |
| ANNUAL REPORT | 2006-03-13 |
| Domestic Profit | 2005-07-25 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
