| Entity Name: | CC PHARMACY DISCOUNT & SUPPLY, CORP. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 17 Aug 2011 (13 years ago) |
| Date of dissolution: | 27 Sep 2013 (11 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2013 (11 years ago) |
| Document Number: | P11000073853 |
| FEI/EIN Number | 453048755 |
| Address: | 10550 SW 8TH STREET, MIAMI, FL, 33174 |
| Mail Address: | 10550 SW 8TH STREET, MIAMI, FL, 33174 |
| ZIP code: | 33174 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1053681585 | 2011-12-30 | 2012-08-13 | 10550 SW 8TH ST, MIAMI, FL, 331742612, US | 10550 SW 8TH ST, MIAMI, FL, 331742612, US | |||||||||||||||||||||||||||
|
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| Phone | +1 305-552-6690 |
| Fax | 3055526689 |
Authorized person
| Name | YOLANDA FALCON |
| Role | OWNER |
| Phone | 3055526690 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH25801 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 5708562 |
| Name | Role | Address |
|---|---|---|
| PEREZ YAIMA | Agent | 10550 SW 8TH STREET, MIAMI, FL, 33174 |
| Name | Role | Address |
|---|---|---|
| AMADOR FALCON YOLANDA D | Vice President | 10550 SW 8TH STREET, MIAMI, FL, 33174 |
| Name | Role | Address |
|---|---|---|
| PEREZ YAIMA | President | 10550 SW 8TH STREET, MIAMI, FL, 33174 |
| Name | Role | Address |
|---|---|---|
| PEREZ YAIMA | Treasurer | 10550 SW 8TH STREET, MIAMI, FL, 33174 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2013-09-27 | No data | No data |
| AMENDMENT | 2012-09-20 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2012-09-20 | PEREZ, YAIMA | No data |
| AMENDMENT | 2012-08-28 | No data | No data |
| AMENDMENT | 2012-07-25 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J13001813816 | LAPSED | 1000000559506 | MIAMI-DADE | 2013-12-09 | 2023-12-26 | $ 538.44 | STATE OF FLORIDA0124139 |
| J13001048868 | TERMINATED | 1000000399987 | MIAMI-DADE | 2013-05-28 | 2033-06-07 | $ 330.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| Name | Date |
|---|---|
| Amendment | 2012-09-20 |
| Amendment | 2012-08-28 |
| Amendment | 2012-07-25 |
| ANNUAL REPORT | 2012-02-24 |
| Domestic Profit | 2011-08-17 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
