Entity Name: | PDI PHARMACY SERVICES, INC. |
Jurisdiction: | FLORIDA |
Filing Type: | Domestic Profit |
Status: | Inactive |
Date Filed: | 16 Mar 1999 (26 years ago) |
Document Number: | P99000023999 |
FEI/EIN Number | 650902543 |
Address: | 6405 CONGRESS AVE, STE 140, BOCA RATON, FL, 33487 |
Mail Address: | C/O BOCA PHARMACY, 22191 POWERLINE RD 22C, BOCA RATON, FL, 33433 |
ZIP code: | 33487 |
County: | Palm Beach |
Place of Formation: | FLORIDA |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1336178243 | 2006-07-02 | 2020-08-22 | 6405 CONGRESS AVE., SUITE 140, BOCA RATON, FL, 334872861, US | 6405 CONGRESS AVE., SUITE 140, BOCA RATON, FL, 334872861, US | |||||||||||||||||||||||||||||||||||||||||||
|
Phone | +1 561-997-0330 |
Fax | 5619972017 |
Authorized person
Name | MR. NORBERT GRABER |
Role | PRESIDENT |
Phone | 5619970330 |
Taxonomy
Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
Is Primary | No |
Taxonomy Code | 332BP3500X - Parenteral & Enteral Nutrition Supplies (DME) |
Is Primary | No |
Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
Is Primary | No |
Taxonomy Code | 3336H0001X - Home Infusion Therapy Pharmacy |
Is Primary | No |
Taxonomy Code | 3336S0011X - Specialty Pharmacy |
Is Primary | No |
Other Provider Identifiers
Issuer | BLUE CROSS BLUE SHIELD |
Number | R9510 |
State | FL |
Issuer | BLUE CROSS BLUE SHIELD |
Number | P7843 |
State | FL |
Name | Role | Address |
---|---|---|
GRABER NORBERT | Agent | 22191 POWERLINE RD, BOCA RATON, FL, 33433 |
Name | Role | Address |
---|---|---|
GRABER NORBERT | Director | 7138 MARIANA COURT, BOCA RATON, FL, 33433 |
ABADY SALVADOR | Director | 22262 HOLLYHOCK TRAIL, BOCA RATON, FL, 33433 |
Event Type | Filed Date | Value | Description |
---|---|---|---|
ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
Date of last update: 03 Jan 2025
Sources: Florida Department of State