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904 PROSPECT PHARMACY, INC.

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Company Details

Name: 904 PROSPECT PHARMACY, INC.
Jurisdiction: New York
Legal type: DOMESTIC BUSINESS CORPORATION
Status: Active
Date of registration: 29 Dec 2004 (20 years ago)
Entity Number: 3142962
ZIP code: 10459
County: Bronx
Place of Formation: New York
Address: 904 Prospect Ave, Bronx, NY, United States, 10459
Principal Address: 904 PROSPECT AVE, BRONX, NY, United States, 10459

Contact Details

Phone +1 718-991-6700

Shares Details

Shares issued 200

Share Par Value 0

Type NO PAR VALUE

Chief Executive Officer

Name Role Address
JACOB TAMRON Chief Executive Officer 904 PROSPECT AVE, BRONX, NY, United States, 10459

DOS Process Agent

Name Role Address
C/O MINTZ & GOLD LLP DOS Process Agent 904 Prospect Ave, Bronx, NY, United States, 10459

National Provider Identifier

NPI Number:
1043307242
Certification Date:
2022-08-29

Authorized Person:

Name:
LOUIS ABT
Role:
COO
Phone:

Taxonomy:

Selected Taxonomy:
333600000X - Pharmacy
Is Primary:
No
Selected Taxonomy:
3336C0003X - Community/Retail Pharmacy
Is Primary:
No
Selected Taxonomy:
3336S0011X - Specialty Pharmacy
Is Primary:
No
Selected Taxonomy:
3336L0003X - Long Term Care Pharmacy
Is Primary:
Yes

Contacts:

Fax:
7188741378

History

Start date End date Type Value
2022-10-25 2023-04-28 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2022-10-14 2022-10-25 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0
2004-12-29 2022-10-14 Shares Share type: NO PAR VALUE, Number of shares: 200, Par value: 0

Filings

Filing Number Date Filed Type Effective Date
221025001484 2022-10-25 BIENNIAL STATEMENT 2020-12-01
171205002013 2017-12-05 BIENNIAL STATEMENT 2016-12-01
120224000148 2012-02-24 ANNULMENT OF DISSOLUTION 2012-02-24
DP-1976110 2011-04-27 DISSOLUTION BY PROCLAMATION 2011-04-27
041229000099 2004-12-29 CERTIFICATE OF INCORPORATION 2004-12-29

Fine And Fees

Fee Sequence Id Fee type Status Date Amount Description
109100 CL VIO INVOICED 2009-05-01 250 CL - Consumer Law Violation

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Date of last update: 29 Mar 2025

Sources: New York Secretary of State