| Entity Name: | BLACK & WHITE PHARMACY , CORP. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 12 Jan 2010 (15 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 23 Sep 2021 (3 years ago) |
| Document Number: | P10000003449 |
| FEI/EIN Number | 271669923 |
| Address: | 8381 SW 40 ST, MIAMI, FL, 33155, US |
| Mail Address: | 8381 SW 40 ST, MIAMI, FL, 33155, US |
| ZIP code: | 33155 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780936476 | 2012-10-05 | 2017-10-26 | 1003 W FLAGLER ST, MIAMI, FL, 331301031, US | 1003 W FLAGLER ST, MIAMI, FL, 331301031, US | |||||||||||||||||||||||||
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| Phone | +1 305-545-2108 |
| Fax | 3055452156 |
Authorized person
| Name | ARSENIO FUNDORA |
| Role | OWNER |
| Phone | 7867033968 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | PH25046 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 003611700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HIDALGO IRMAYLIN | Agent | 8381 SW 40 ST, MIAMI, FL, 33155 |
| Name | Role | Address |
|---|---|---|
| HIDALGO IRMAYLIN | President | 8381 SW 40 ST, MIAMI, FL, 33155 |
| Name | Role | Address |
|---|---|---|
| HIDALGO IRMAYLIN | Vice President | 8381 SW 40 ST, MIAMI, FL, 33155 |
| Name | Role | Address |
|---|---|---|
| HIDALGO IRMAYLIN | Secretary | 8381 SW 40 ST, MIAMI, FL, 33155 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2021-09-23 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2021-09-23 | 8381 SW 40 ST, MIAMI, FL 33155 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-09-23 | 8381 SW 40 ST, MIAMI, FL 33155 | No data |
| AMENDMENT | 2021-06-11 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2021-05-10 | HIDALGO, IRMAYLIN | No data |
| AMENDMENT | 2021-05-10 | No data | No data |
| AMENDMENT | 2015-12-17 | No data | No data |
| AMENDMENT | 2014-08-19 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2010-10-29 | 8381 SW 40 ST, MIAMI, FL 33155 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-22 |
| ANNUAL REPORT | 2023-02-23 |
| ANNUAL REPORT | 2022-04-11 |
| Amendment | 2021-09-23 |
| Amendment | 2021-06-11 |
| Amendment | 2021-05-10 |
| ANNUAL REPORT | 2021-01-29 |
| ANNUAL REPORT | 2020-01-21 |
| ANNUAL REPORT | 2019-02-08 |
| ANNUAL REPORT | 2018-01-16 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
