| Entity Name: | NORTH FLORIDA PHARMACY OF MADISON, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 15 Dec 2005 (19 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 15 Jul 2015 (10 years ago) |
| Document Number: | P05000163570 |
| FEI/EIN Number | 20-3974955 |
| Address: | 1756 SW BARNETT WAY, LAKE CITY, FL 32025 |
| Mail Address: | 1756 SW BARNETT WAY, LAKE CITY, FL 32025 |
| ZIP code: | 32025 |
| County: | Columbia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306032073 | 2007-09-17 | 2024-06-04 | 139 SW MACON STREET, MADISON, FL, 323402319, US | 139 SW MACON ST, MADISON, FL, 32340, US | |||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 850-973-8120 |
| Fax | 8509738122 |
Authorized person
| Name | JOEL E ROSENFELD |
| Role | OWNER |
| Phone | 3867586770 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| License Number | PH22887 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH22887 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 032228800 |
| State | FL |
| Issuer | MEDICAID |
| Number | 032228801 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| TORRANS, ALFRED WII | Agent | 1756 SW BARNETT WAY, LAKE CITY, FL 32025 |
| Name | Role | Address |
|---|---|---|
| TORRANS, ALFRED WII | President | 1756 SW BARNETT WAY, LAKE CITY, FL 32025 |
| Name | Role | Address |
|---|---|---|
| TORRANS, ALFRED WII | Secretary | 1756 SW BARNETT WAY, LAKE CITY, FL 32025 |
| Name | Role | Address |
|---|---|---|
| TORRANS, ALFRED WII | Treasurer | 1756 SW BARNETT WAY, LAKE CITY, FL 32025 |
| Name | Role | Address |
|---|---|---|
| ROSENFELD, JOEL | Vice President | 4706 SW SR 47, LAKE CITY, FL 32024 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2015-07-15 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2006-04-20 | TORRANS, ALFRED WII | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-14 |
| ANNUAL REPORT | 2023-01-27 |
| ANNUAL REPORT | 2022-02-08 |
| ANNUAL REPORT | 2021-04-22 |
| ANNUAL REPORT | 2020-04-05 |
| ANNUAL REPORT | 2019-04-16 |
| ANNUAL REPORT | 2018-04-18 |
| ANNUAL REPORT | 2017-04-19 |
| ANNUAL REPORT | 2016-04-16 |
| Amendment | 2015-07-15 |
Date of last update: 03 Jan 2025
Sources: Florida Department of State
