POLK CITY PHARMACY INC
Pharmacy at Commonwealth Ave, Polk City, FL

License number
Florida PH21515
Category
Suppliers
Type
Pharmacy
Owner
Name: JACQUELINE A FUTCH PHARMD
Title: OWNER PHARMACIST
Phone: (863) 984-9631
Address
Address
108 N Commonwealth Ave, Polk City, FL 33868
National Provider ID: 1417040486
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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POLK CITY PHARMACY, INC

Polk City, FL

Status:
Inactive
Inactive reason:
ADMIN DISSOLUTION FOR ANNUAL REPORT
Registration:
Jul 28, 2005
Inactive since:
Sep 25, 2009
Addresses:
108 N Commonwealth Rd, Polk City, FL 33868 (Physical)
12500 Old Grade Rd, Polk City, FL 33868 (Mailing)
108 N Commonwealth Ave, Polk City, FL 33868
State ID:
P05000105341
Business type:
Florida Profit Corporation
President, Treasurer, Vice Presidents:
Jacqueline A Futch President, Secretary, inactive, 12500 Old Grade Rd, Polk City, FL 33868 (Physical),William W Futch President, Treasurer, Vice President, inactive
Agent:
Jacqueline Futch,12500 Old Grade Rd, Polk City, FL 33868 (Physical)
EIN:
54-2179512

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