| Entity Name: | CLOSED DOOR PHARMACY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 29 Jan 2018 (7 years ago) |
| Document Number: | P18000009597 |
| FEI/EIN Number | 82-4183040 |
| Address: | 7481 W. OAKLAND PARK BOULEVARD, SUITE 203F, LAUDERHILL, FL 33319 |
| Mail Address: | 1065 NE 125th Street, Ste 300, SUITE 300, North Miami, FL 33161 |
| ZIP code: | 33319 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295274066 | 2017-02-14 | 2018-07-19 | 1065 NE 125TH ST, SUITE 207, NORTH MIAMI, FL, 331615821, US | 1065 NE 125TH ST STE 207, NORTH MIAMI, FL, 331615832, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 786-347-0365 |
| Fax | 7863470321 |
Authorized person
| Name | SCOTT SEGAL |
| Role | CEO/PRESIDENT |
| Phone | 3058910050 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| License Number | PH30439 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 016594200 |
| State | FL |
| Issuer | PK |
| Number | 2167828 |
| Name | Role | Address |
|---|---|---|
| SEGAL, SCOTT D | Agent | 1065 NE 125TH STE 300, NORTH MIAMI, FL 33161 |
| Name | Role | Address |
|---|---|---|
| SEGAL, SCOTT D | President | 1065 NE 125TH STE 300, NORTH MIAMI, FL 33161 UN |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2019-05-14 | 7481 W. OAKLAND PARK BOULEVARD, SUITE 203F, LAUDERHILL, FL 33319 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-06-04 | 7481 W. OAKLAND PARK BOULEVARD, SUITE 203F, LAUDERHILL, FL 33319 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-22 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-02-22 |
| ANNUAL REPORT | 2021-05-01 |
| ANNUAL REPORT | 2020-02-05 |
| ANNUAL REPORT | 2019-05-14 |
| Domestic Profit | 2018-01-29 |
Date of last update: 18 Jan 2025
Sources: Florida Department of State
