| Entity Name: | CALLAWAY GULF COAST PHARMACY CO |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 10 Feb 2015 (10 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 03 Sep 2019 (5 years ago) |
| Document Number: | P15000013672 |
| FEI/EIN Number | 47-3137094 |
| Address: | 420 N TYNDALL PKWY, PANAMA CITY, FL 32404 |
| Mail Address: | 420 N TYNDALL PKWY, PANAMA CITY 32404 UN |
| ZIP code: | 32404 |
| County: | Bay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1790162311 | 2015-05-04 | 2021-02-04 | 420 N TYNDALL PKWY, PANAMA CITY, FL, 324046125, US | 420 N TYNDALL PKWY, PANAMA CITY, FL, 324046125, US | |||||||||||||||||||||
|
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| Phone | +1 850-615-2000 |
Authorized person
| Name | ADEL EBRAHIM |
| Role | PRESIDENT |
| Phone | 8503193238 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH29076 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2151701 |
| Name | Role | Address |
|---|---|---|
| EBRAHIM, ADEL | Agent | 420 N TYNDALL PKWAY, CALLAWAY, FL 32404 |
| Name | Role | Address |
|---|---|---|
| ABDEL-RAHIM, AHMAD | President | 420 tyndall pkway, callway, FL 32404 |
| Name | Role | Address |
|---|---|---|
| EBRAHIM, ADEL | Vice President | 420 N tyndall pkway, callaway, FL 32404 |
| Name | Role | Address |
|---|---|---|
| SHALABY, MAGED | Treasurer | 2605 PARKWOOD DRIVE, PANAMA CITY, FL 32405 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2019-09-03 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-02-21 | 420 N TYNDALL PKWY, PANAMA CITY, FL 32404 | No data |
| CHANGE OF MAILING ADDRESS | 2017-02-21 | 420 N TYNDALL PKWY, PANAMA CITY, FL 32404 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2016-02-18 | 420 N TYNDALL PKWAY, CALLAWAY, FL 32404 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-25 |
| ANNUAL REPORT | 2023-04-10 |
| ANNUAL REPORT | 2022-03-13 |
| ANNUAL REPORT | 2021-03-27 |
| ANNUAL REPORT | 2020-04-03 |
| Amendment | 2019-09-03 |
| ANNUAL REPORT | 2019-03-30 |
| ANNUAL REPORT | 2018-03-04 |
| ANNUAL REPORT | 2017-02-21 |
| ANNUAL REPORT | 2016-02-18 |
Date of last update: 21 Jan 2025
Sources: Florida Department of State
