| Entity Name: | FOLKLORE PHARMACY DISCOUNT, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 13 Sep 2005 (19 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: | P05000125932 |
| FEI/EIN Number | 203510091 |
| Address: | 12800 S W 8TH ST, MIAMI, FL, 33184 |
| Mail Address: | 12800 S W 8TH ST, MIAMI, FL, 33184 |
| ZIP code: | 33184 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1194746149 | 2006-07-22 | 2011-10-14 | 12812 SW 8TH ST, MIAMI, FL, 331841309, US | 12812 SW 8TH ST, MIAMI, FL, 331841309, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 305-221-0726 |
| Fax | 3055538889 |
Authorized person
| Name | ALEXANDER OTERO |
| Role | PRESIDENT |
| Phone | 3052210726 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH21698 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 1017462 |
| Issuer | MEDICAID |
| Number | 565531001 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| OTERO ALEXANDER I | Agent | 12800 S W 8TH ST, MIAMI, FL, 33184 |
| Name | Role | Address |
|---|---|---|
| OTERO ALEXANDER I | President | 1719 W 56TH TERR, HIALEAH, FL, 33012 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-05-01 | 12800 S W 8TH ST, MIAMI, FL 33184 | No data |
| CHANGE OF MAILING ADDRESS | 2010-05-01 | 12800 S W 8TH ST, MIAMI, FL 33184 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-05-01 | 12800 S W 8TH ST, MIAMI, FL 33184 | No data |
| REGISTERED AGENT NAME CHANGED | 2007-05-02 | OTERO, ALEXANDER I | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-04-19 |
| ANNUAL REPORT | 2012-03-28 |
| ANNUAL REPORT | 2011-04-17 |
| ANNUAL REPORT | 2010-05-01 |
| ANNUAL REPORT | 2009-06-17 |
| ANNUAL REPORT | 2008-04-18 |
| ANNUAL REPORT | 2007-05-02 |
| ANNUAL REPORT | 2006-04-13 |
| Domestic Profit | 2005-09-13 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
