| Entity Name: | BLUE STAR PHARMACY INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 14 May 2010 (15 years ago) |
| Date of dissolution: | 22 Sep 2017 (7 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 22 Sep 2017 (7 years ago) |
| Document Number: | P10000042025 |
| FEI/EIN Number | 27-2599638 |
| Address: | 3009 SW 107 AVENUE, MIAMI, FL 33165 |
| Mail Address: | 3009 SW 107 AVENUE, MIAMI, FL 33165 |
| ZIP code: | 33165 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417263104 | 2010-08-19 | 2015-03-31 | 3009 SW 107TH AVE, MIAMI, FL, 331652434, US | 3009 SW 107TH AVE, MIAMI, FL, 331652434, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 305-222-1818 |
| Fax | 3052221819 |
Authorized person
| Name | JOSE HERNANDEZ |
| Role | PRESIDENT |
| Phone | 3052221818 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH24830 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2126323 |
| Issuer | MEDICAID |
| Number | 003954400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ, JOSE A | Agent | 3009 SW 107 AVENUE, MIAMI, FL 33165 |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ, JOSE A | President | 3009 SW 107 AVENUE, MIAMI, FL 33165 |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ, JOSE A | Director | 3009 SW 107 AVENUE, MIAMI, FL 33165 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2014-04-28 | HERNANDEZ, JOSE A | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-04-26 | 3009 SW 107 AVENUE, MIAMI, FL 33165 | No data |
| CHANGE OF MAILING ADDRESS | 2011-04-26 | 3009 SW 107 AVENUE, MIAMI, FL 33165 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-04-26 | 3009 SW 107 AVENUE, MIAMI, FL 33165 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2016-04-27 |
| ANNUAL REPORT | 2015-04-27 |
| ANNUAL REPORT | 2014-04-28 |
| ANNUAL REPORT | 2013-04-29 |
| ANNUAL REPORT | 2012-04-24 |
| ANNUAL REPORT | 2011-04-26 |
| Domestic Profit | 2010-05-14 |
Date of last update: 25 Jan 2025
Sources: Florida Department of State
