| Entity Name: | ACARIAHEALTH PHARMACY #26, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Profit |
| Status: | Active |
| Date Filed: | 12 Mar 2007 (18 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 29 Dec 2021 (3 years ago) |
| Document Number: | F07000001376 |
| FEI/EIN Number | 208420512 |
| Mail Address: | 7700 Forsyth Blvd., St. Louis, MO, 63105, US |
| Address: | 8715 HENDERSON RD, TAMPA, FL, 33634, US |
| ZIP code: | 33634 |
| County: | Hillsborough |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1073733408 | 2007-04-26 | 2024-02-09 | 8715 HENDERSON RD, TAMPA, FL, 336341143, US | 8715 HENDERSON RD, TAMPA, FL, 336341143, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 866-458-9246 |
| Fax | 8864589245 |
| Fax | 8664589245 |
Authorized person
| Name | JESSICA DAWN CICCOLELLA-KAHL |
| Role | PRESIDENT |
| Phone | 8554222742 |
Taxonomy
| Taxonomy Code | 251F00000X - Home Infusion Agency |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH22669 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 1073733408 |
| State | IA |
| Issuer | PHARMACY LICENSE |
| Number | PH22669 |
| State | FL |
| Issuer | MEDICAID |
| Number | 1073733408 |
| State | NC |
| Issuer | MEDICAID |
| Number | 1073733408 |
| State | OH |
| Issuer | MEDICAID |
| Number | 3014228 |
| State | UT |
| Issuer | MEDICAID |
| Number | 3128603 |
| State | NH |
| Issuer | MEDICAID |
| Number | 0387550 |
| State | NJ |
| Issuer | MEDICAID |
| Number | 05743811 |
| State | NY |
| Issuer | MEDICAID |
| Number | 10026581500 |
| State | NE |
| Issuer | MEDICAID |
| Number | 1073733408 |
| State | HI |
| Issuer | MEDICAID |
| Number | 1073733408 |
| State | AZ |
| Issuer | MEDICAID |
| Number | 1073733408 |
| State | NM |
| Issuer | MEDICAID |
| Number | 7F2669 |
| State | SC |
| Issuer | MEDICAID |
| Number | 241842 |
| State | AZ |
| Issuer | MEDICAID |
| Number | 7100220090 |
| State | KY |
| Issuer | MEDICAID |
| Number | 103767416 |
| State | PA |
| Issuer | MEDICAID |
| Number | 1073733408 |
| State | MI |
| Issuer | MEDICAID |
| Number | 300038102 |
| State | IN |
| Issuer | MEDICAID |
| Number | 032112500 |
| State | FL |
| Issuer | MEDICAID |
| Number | 2157757 |
| State | WA |
| Issuer | MEDICAID |
| Number | 1073733408 |
| State | CA |
| Issuer | MEDICAID |
| Number | 500778781 |
| State | OR |
| Issuer | MEDICAID |
| Number | 582077 |
| State | TX |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| Ciccolella-Kahl Jessica | President | 8517 South Park Circle, Orlando, FL, 32819 |
| Name | Role | Address |
|---|---|---|
| Dinkelman Tricia | Vice President | 7700 Forsyth Blvd., St. Louis, MO, 63105 |
| Name | Role | Address |
|---|---|---|
| STUBSTAD JUSTIN | Secretary | 7700 FORSYTH BLVD, ST LOUIS, MO, 63105 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2021-12-29 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2021-07-20 | 8715 HENDERSON RD, TAMPA, FL 33634 | No data |
| NAME CHANGE AMENDMENT | 2021-07-19 | ACARIAHEALTH PHARMACY #26, INC. | No data |
| CHANGE OF MAILING ADDRESS | 2021-04-27 | 8715 HENDERSON RD, TAMPA, FL 33634 | No data |
| NAME CHANGE AMENDMENT | 2012-02-01 | EXACTUS PHARMACY SOLUTIONS, INC. | No data |
| REGISTERED AGENT NAME CHANGED | 2009-09-14 | CT CORPORATION SYSTEM | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2009-09-14 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-04-25 |
| Amendment | 2021-12-29 |
| Name Change | 2021-07-19 |
| ANNUAL REPORT | 2021-04-27 |
| ANNUAL REPORT | 2020-03-05 |
| ANNUAL REPORT | 2019-03-01 |
| ANNUAL REPORT | 2018-03-14 |
| ANNUAL REPORT | 2017-03-01 |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
