| Entity Name: | MELODY PHARMACY INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 04 Jan 2012 (13 years ago) |
| Document Number: | P12000001299 |
| FEI/EIN Number | 45-4486089 |
| Address: | 17639 NW 27TH AVE., MIAMI GARDENS, FL, 33056, 07 |
| Mail Address: | 17639 NW 27TH AVE., MIAMI GARDENS, FL, 33056, 07 |
| ZIP code: | 33056 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003181835 | 2012-03-12 | 2017-03-10 | 17639 NW 27TH AVE, MIAMI GARDENS, FL, 330564007, US | 17639 NW 27TH AVE, MIAMI GARDENS, FL, 330564007, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 305-625-0018 |
| Fax | 3056250020 |
Authorized person
| Name | MICHAEL EGBERONGBE |
| Role | PRESIDENT, RPH |
| Phone | 3056250018 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH26044 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2134690 |
| Issuer | MEDICAID |
| Number | 000000000 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| EGBERONGBE MICHAEL ASR | Agent | 17639 NW 27TH AVE., MIAMI GARDENS, FL, 33056 |
| Name | Role | Address |
|---|---|---|
| EGBERONGBE MICHAEL A | President | 17639 NW 27TH AVE., MIAMI GARDENS, FL, 33056 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2015-08-03 | 17639 NW 27TH AVE., MIAMI GARDENS, FL 33056 07 | No data |
| CHANGE OF MAILING ADDRESS | 2015-08-03 | 17639 NW 27TH AVE., MIAMI GARDENS, FL 33056 07 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-07-27 | 17639 NW 27TH AVE., MIAMI GARDENS, FL 33056 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-04 |
| ANNUAL REPORT | 2023-03-21 |
| ANNUAL REPORT | 2022-02-17 |
| ANNUAL REPORT | 2021-02-03 |
| ANNUAL REPORT | 2020-03-27 |
| ANNUAL REPORT | 2019-02-22 |
| ANNUAL REPORT | 2018-01-15 |
| ANNUAL REPORT | 2017-04-05 |
| ANNUAL REPORT | 2016-02-23 |
| Reg. Agent Change | 2015-07-27 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
