| Entity Name: | CHARLES PLAZA PHARMACY, INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 26 May 2010 (15 years ago) |
| Date of dissolution: | 28 Sep 2012 (12 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 28 Sep 2012 (12 years ago) |
| Document Number: | P10000045576 |
| FEI/EIN Number | 272709990 |
| Address: | 5448 N. UNIVERSITY DRIVE, LAUDERHILL, FL, 33319 |
| Mail Address: | 5448 N. UNIVERSITY DRIVE, LAUDERHILL, FL, 33319 |
| ZIP code: | 33319 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861700791 | 2010-09-14 | 2011-02-02 | 5448 N UNIVERSITY DR, LAUDERHILL, FL, 333515006, US | 5448 N UNIVERSITY DR, LAUDERHILL, FL, 333515006, US | |||||||||||||||||||||||
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| Phone | +1 954-626-0626 |
| Fax | 9546260577 |
Authorized person
| Name | JATINKUMAR PATEL |
| Role | PRESIDENT |
| Phone | 5618767247 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH 24871 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 5701708 |
| Name | Role | Address |
|---|---|---|
| BAROUH RICHARD | Agent | 10800 NW 5TH ST, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| PATEL JATINKUMAR | President | 10360 FOX TRAIL S, WEST PALM BCH, FL, 33411 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2012-09-28 | No data | No data |
| AMENDMENT | 2010-08-20 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2010-08-20 | 5448 N. UNIVERSITY DRIVE, LAUDERHILL, FL 33319 | No data |
| CHANGE OF MAILING ADDRESS | 2010-08-20 | 5448 N. UNIVERSITY DRIVE, LAUDERHILL, FL 33319 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2011-01-22 |
| Amendment | 2010-08-20 |
| Domestic Profit | 2010-05-26 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
