| Entity Name: | LIFE PHARMA CORP |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 22 Aug 2022 (2 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 29 Feb 2024 (a year ago) |
| Document Number: | P22000066112 |
| FEI/EIN Number | N/A |
| Address: | 1109 NW 22 AVE, MIAMI, FL 33125 |
| Mail Address: | 1109 NW 22 AVE, MIAMI, FL 33125 |
| ZIP code: | 33125 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1962123778 | 2022-09-09 | 2022-12-09 | 1109 NW 22ND AVE, MIAMI, FL, 33125, US | 1109 NW 22ND AVE, MIAMI, FL, 33125, US | |||||||||||||||||||||
|
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| Phone | +1 305-646-1111 |
| Fax | 7867031242 |
Authorized person
| Name | JORGE L HERNANDEZ LARA |
| Role | PRESIDENT |
| Phone | 3056461111 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | 3888 |
| Number | NUMBER |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ, JORGE L | Agent | 1109 NW 22 AVE, MIAMI, FL 33125 |
| Name | Role | Address |
|---|---|---|
| HERNANDEZ LARA, JORGE L | President | 1109 NW 22 AVENUE, MIAMI, FL 33125 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000045463 | MAR-LAC PHARMACY DISCOUNT & SUPPLY | ACTIVE | 2024-04-02 | 2029-12-31 | No data | 1109 NW 22 AVE, MIAMI, FL, 33125 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2024-02-29 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2024-02-29 | HERNANDEZ, JORGE L | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2023-09-22 | No data | No data |
| AMENDMENT | 2022-11-28 | No data | No data |
| AMENDMENT | 2022-11-01 | No data | No data |
| AMENDMENT | 2022-08-29 | No data | No data |
| Name | Date |
|---|---|
| REINSTATEMENT | 2024-02-29 |
| Amendment | 2022-11-28 |
| Amendment | 2022-11-01 |
| Amendment | 2022-08-29 |
| Domestic Profit | 2022-08-22 |
Date of last update: 11 Feb 2025
Sources: Florida Department of State
