Entity Name: | PREMIUM PHARMACY, INC. |
Jurisdiction: | FLORIDA |
Filing Type: | Domestic Profit |
Status: | Active |
Date Filed: | 13 Jun 2007 (18 years ago) |
Document Number: | P07000069096 |
FEI/EIN Number | 260348061 |
Address: | 8901 SW 157TH AVE, SUITE 3, MIAMI, FL, 33196 |
Mail Address: | 8901 SW 157TH AVE, SUITE 3, MIAMI, FL, 33196 |
ZIP code: | 33196 |
County: | Miami-Dade |
Place of Formation: | FLORIDA |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1578728895 | 2008-07-25 | 2011-10-07 | 8901 SW 157TH AVE, STE 3, MIAMI, FL, 331961102, US | 8901 SW 157TH AVE, STE 3, MIAMI, FL, 331961102, US | |||||||||||||||||||||||
|
Phone | +1 305-385-2900 |
Fax | 3053852999 |
Authorized person
Name | MRS. YUDITH FERNANDEZ |
Role | OWNER |
Phone | 3053852900 |
Taxonomy
Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
License Number | PH23505 |
State | FL |
Is Primary | Yes |
Other Provider Identifiers
Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
Number | 1036854 |
Name | Role | Address |
---|---|---|
FERNANDEZ YUDITH | Agent | 14405 SW 45TH TERRACE, MIAMI, FL, 33175 |
Name | Role | Address |
---|---|---|
FERNANDEZ YUDITH | President | 14405 SW 45TH TERRACE, MIAMI, FL, 33175 |
Name | Role | Address |
---|---|---|
Sole Salvador Sr. | Vice President | 8901 SW 157TH AVE, MIAMI, FL, 33196 |
Event Type | Filed Date | Value | Description |
---|---|---|---|
CHANGE OF PRINCIPAL ADDRESS | 2008-04-08 | 8901 SW 157TH AVE, SUITE 3, MIAMI, FL 33196 | No data |
CHANGE OF MAILING ADDRESS | 2008-04-08 | 8901 SW 157TH AVE, SUITE 3, MIAMI, FL 33196 | No data |
Name | Date |
---|---|
ANNUAL REPORT | 2024-02-01 |
ANNUAL REPORT | 2023-02-15 |
ANNUAL REPORT | 2022-03-08 |
ANNUAL REPORT | 2021-04-20 |
ANNUAL REPORT | 2020-03-18 |
ANNUAL REPORT | 2019-03-29 |
ANNUAL REPORT | 2018-03-22 |
ANNUAL REPORT | 2017-04-04 |
ANNUAL REPORT | 2016-03-09 |
ANNUAL REPORT | 2015-02-11 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State