| Entity Name: | CALLAHAN PHARMACY INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 19 Oct 2009 (15 years ago) |
| Date of dissolution: | 28 Sep 2018 (6 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2018 (6 years ago) |
| Document Number: | P09000086060 |
| FEI/EIN Number | 271146188 |
| Address: | 450077 STATE RD 200, CALLAHAN, FL, 32011 |
| Mail Address: | 2704 SECRET HARBOR DR, ORANGE PARK, FL, 32065 |
| ZIP code: | 32011 |
| County: | Nassau |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306177530 | 2010-01-28 | 2017-02-20 | 2704 SECRET HARBOR DR, ORANGE PARK, FL, 320657675, US | 450077 STATE ROAD 200, CALLAHAN, FL, 320113863, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 904-651-0055 |
| Phone | +1 904-628-0365 |
| Fax | 9046280380 |
Authorized person
| Name | ABDALLA ADAM |
| Role | PRESIDENT/PHARMACIST IN CHARGE |
| Phone | 9046510055 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH24482 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 002370200 |
| State | FL |
| Issuer | PK |
| Number | 2124046 |
| Name | Role | Address |
|---|---|---|
| ADAM ABDALLA M | Agent | 2704 SECRET HARBOR DR, ORANGE PARK, FL, 32065 |
| Name | Role | Address |
|---|---|---|
| ADAM ABDALLA M | President | 2704 SECRET HARBOR DR, ORANGE PARK, FL, 32065 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-01-12 | 450077 STATE RD 200, CALLAHAN, FL 32011 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2017-02-06 |
| ANNUAL REPORT | 2016-01-15 |
| ANNUAL REPORT | 2015-01-22 |
| ANNUAL REPORT | 2014-01-10 |
| ANNUAL REPORT | 2013-01-10 |
| ANNUAL REPORT | 2012-01-12 |
| ANNUAL REPORT | 2011-03-23 |
| ANNUAL REPORT | 2010-04-02 |
| Domestic Profit | 2009-10-19 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
