| Entity Name: | CRAWFORDVILLE PHARMACY INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 24 Jan 2017 (8 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 09 Sep 2022 (2 years ago) |
| Document Number: | P17000007831 |
| FEI/EIN Number | 81-5124850 |
| Address: | 3362 JASMINE HILL ROAD, TALLAHASSEE, FL, 32311 |
| Mail Address: | 3362 JASMINE HILL ROAD, TALLAHASSEE, FL, 32311 |
| ZIP code: | 32311 |
| County: | Leon |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598204547 | 2017-02-22 | 2018-06-17 | 2650 CRAWFORDVILLE HWY STE 1, CRAWFORDVILLE, FL, 323272369, US | 2650 CRAWFORDVILLE HWY, SUITE 1, CRAWFORDVILLE, FL, 32327, US | |||||||||||||||||||||||||||
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| Phone | +1 352-874-9878 |
| Fax | 3528749878 |
Authorized person
| Name | HIREN PATEL |
| Role | OWNER |
| Phone | 3528749878 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH30647 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2168095 |
| Name | Role | Address |
|---|---|---|
| PATEL HIREN | Agent | 3362 JASMINE HILL ROAD, TALLAHASSEE, FL, 32311 |
| Name | Role | Address |
|---|---|---|
| PATEL HIREN | President | 2650 CRAWFORDVILLE HIGHWAY, SUITE 1, CRAWFORDVILLE, FL, 32327 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000021807 | CRAWFORDVILLE PHARMACY | ACTIVE | 2017-02-28 | 2027-12-31 | No data | 3362 JASMINE HILL ROAD, TALLAHASSEE, FL, 32311 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2022-09-09 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-09-09 | 3362 JASMINE HILL ROAD, TALLAHASSEE, FL 32311 | No data |
| CHANGE OF MAILING ADDRESS | 2022-09-09 | 3362 JASMINE HILL ROAD, TALLAHASSEE, FL 32311 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-09-09 | 3362 JASMINE HILL ROAD, TALLAHASSEE, FL 32311 | No data |
| AMENDMENT | 2019-05-16 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-02-10 |
| Amendment | 2022-09-09 |
| ANNUAL REPORT | 2022-01-29 |
| ANNUAL REPORT | 2021-02-07 |
| ANNUAL REPORT | 2020-04-05 |
| Amendment | 2019-05-16 |
| ANNUAL REPORT | 2019-04-10 |
| ANNUAL REPORT | 2018-04-02 |
| Domestic Profit | 2017-01-24 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
