| Entity Name: | CITIPHARM, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 06 Aug 2010 (14 years ago) |
| Document Number: | P10000064752 |
| FEI/EIN Number | 273205398 |
| Address: | 1401 S MILITARY TRAIL, WEST PALM BEACH, FL, 33415, US |
| Mail Address: | P. O. BOX 17175, TAMPA, FL, 33682, US |
| ZIP code: | 33415 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336440890 | 2010-11-15 | 2022-11-16 | PO BOX 17175, TAMPA, FL, 336827175, US | 1401 S MILITARY TRAIL, SUITE I-2, WEST PALM BEACH, FL, 334155641, US | |||||||||||||||||||||||||||
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| Phone | +1 561-268-0888 |
| Fax | 5612680606 |
Authorized person
| Name | STEPHEN O BANJOKO |
| Role | CFO |
| Phone | 8133414000 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 20 |
| State | FL |
| Issuer | MEDICAID |
| Number | 104325700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| BANJOKO BAMIDELE | Agent | 10549 N FLORIDA AVE, TAMPA, FL, 33612 |
| Name | Role | Address |
|---|---|---|
| BANJOKO STEPHEN O | Chief Financial Officer | P. O. BOX 17175, TAMPA, FL, 33682 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000043070 | BAY AREA PHARMACY | ACTIVE | 2023-04-04 | 2028-12-31 | No data | 1721 W FLETCHER AVE, TAMPA, FL, 33612 |
| G18000038391 | SOUTH FLORIDA PHARMACY | EXPIRED | 2018-03-22 | 2023-12-31 | No data | 6835 4TH ST N, ST PETERSBURG, FL, 33702-6844 |
| G12000036285 | SOUTH FLORIDA PHARMACY | EXPIRED | 2012-04-16 | 2017-12-31 | No data | 2810 S FLORIDA AVENUE, SUITE A, LAKELAND, FL, 33803 |
| G10000073412 | CITI PHARMACY | EXPIRED | 2010-08-10 | 2015-12-31 | No data | 325 WEST OAK STREET, KISSIMMEE, FL, 34741 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-04 | 1401 S MILITARY TRAIL, I-2, WEST PALM BEACH, FL 33415 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-04-30 | 10549 N FLORIDA AVE, SUITE A, TAMPA, FL 33612 | No data |
| CHANGE OF MAILING ADDRESS | 2021-03-10 | 1401 S MILITARY TRAIL, I-2, WEST PALM BEACH, FL 33415 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-03-10 | BANJOKO, BAMIDELE | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-04 |
| ANNUAL REPORT | 2022-04-30 |
| AMENDED ANNUAL REPORT | 2021-03-18 |
| ANNUAL REPORT | 2021-03-10 |
| AMENDED ANNUAL REPORT | 2020-07-07 |
| ANNUAL REPORT | 2020-06-19 |
| AMENDED ANNUAL REPORT | 2019-10-08 |
| AMENDED ANNUAL REPORT | 2019-08-28 |
| ANNUAL REPORT | 2019-03-20 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
