| Entity Name: | INFUSION SYSTEMS INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 22 Apr 1998 (27 years ago) |
| Document Number: | P98000036356 |
| FEI/EIN Number | 650829825 |
| Address: | 930 NE 96TH STREET, MIAMI, FL, 33138 |
| Mail Address: | 930 NE 96TH STREET, MIAMI, FL, 33138 |
| ZIP code: | 33138 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023024635 | 2006-08-01 | 2010-03-12 | 3890 TAMIAMI TRL, STE C, PORT CHARLOTTE, FL, 339528401, US | 3890 TAMIAMI TRL, STE C, PORT CHARLOTTE, FL, 339528401, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 941-629-7784 |
| Fax | 9416274369 |
Authorized person
| Name | JEFF STEELE |
| Role | VP |
| Phone | 9416294666 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH13654 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 1041540 |
| Issuer | MEDICAID |
| Number | 104862700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| HARDY DUARD I | Agent | 930 NE 96TH ST, MIAMI, FL, 33138 |
| Name | Role | Address |
|---|---|---|
| HARDY DUARD | Director | 930 NE 96TH STREET, MIAMI, FL, 33138 |
| MARTEL LEO | Director | 930 NE 96TH STREET, MIAMI, FL, 33138 |
| HARDY LILIAN | Director | 930 NE 96TH STREET, MIAMI, FL, 33138 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2001-09-21 | No data | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
