| Entity Name: | ACARIAHEALTH PHARMACY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Profit |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 03 Oct 2012 (13 years ago) |
| Document Number: | F12000004060 |
| FEI/EIN Number |
13-4262384
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Mail Address: | 7700 Forsyth Blvd., St. Louis, MO, 63105, US |
| Address: | 8517 SOUTHPARK CIRCLE, ORLANDO, FL, 32819, US |
| ZIP code: | 32819 |
| County: | Orange |
| Place of Formation: | CALIFORNIA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851631980 | 2013-02-27 | 2021-05-24 | 8427 SOUTHPARK CIR STE 400, ORLANDO, FL, 328199057, US | 6923 LEE VISTA BLVD STE 200, ORLANDO, FL, 328224703, US | |||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 855-422-2742 |
| Fax | 8668348523 |
| Phone | +1 407-903-1308 |
| Fax | 8776170830 |
Authorized person
| Name | STEPHEN JENSEN |
| Role | PRESIDENT |
| Phone | 8005115144 |
Taxonomy
| Taxonomy Code | 251F00000X - Home Infusion Agency |
| Is Primary | No |
| Taxonomy Code | 332BP3500X - Parenteral & Enteral Nutrition Supplies (DME) |
| License Number | PH26727 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 333600000X - Pharmacy |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH26727 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 008459600 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PROSPERITY PHARMACY 401(K) PLAN | 2013 | 134262384 | 2014-10-01 | ACARIAHEALTH PHARMACY INC. | 36 | |||||||||||||||||||||||||||||||||||||||||||
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| PROSPERITY PHARMACY 401(K) PLAN | 2012 | 134262384 | 2013-10-14 | ACARIAHEALTH PHARMACY INC. | 53 | |||||||||||||||||||||||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2013-10-14 |
| Name of individual signing | CYNTHIA L. PRIMM |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2013-10-14 |
| Name of individual signing | CYNTHIA L. PRIMM |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2005-01-01 |
| Business code | 621900 |
| Sponsor’s telephone number | 4079031308 |
| Plan sponsor’s mailing address | 6923 LEE VISTA BLVD, SUITE 300, ORLANDO, FL, 32822 |
| Plan sponsor’s address | 6923 LEE VISTA BLVD, SUITE 300, ORLANDO, FL, 32822 |
Plan administrator’s name and address
| Administrator’s EIN | 134262384 |
| Plan administrator’s name | ACARIAHEALTH PHARMACY, INC. |
| Plan administrator’s address | 6923 LEE VISTA BLVD, SUITE 300, ORLANDO, FL, 32822 |
| Administrator’s telephone number | 4079031308 |
Number of participants as of the end of the plan year
| Active participants | 139 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 12 |
| Number of participants with account balances as of the end of the plan year | 53 |
| Number of participants that terminated employment during the plan year with accrued benefits that were less than 100% vested | 0 |
Signature of
| Role | Plan administrator |
| Date | 2012-10-15 |
| Name of individual signing | CYNTHIA PRIMM |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Dinkelman Tricia | Vice President | 7700 Forsyth Blvd, St. Louis, MO, 63105 |
| Ciccolella-Kahl Jessica | President | 8517 SOUTHPARK CIRCLE, ORLANDO, FL, 32819 |
| Stubstad Justin | Secretary | 7700 Forsyth Blvd, St. Louis, MO, 63105 |
| CT CORPORATION SYSTEM | Agent | 1200 S PINE ISLAND RD, PLANTATION, FL, 33324 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-27 | 8517 SOUTHPARK CIRCLE, ORLANDO, FL 32819 | - |
| CHANGE OF MAILING ADDRESS | 2021-04-26 | 8517 SOUTHPARK CIRCLE, ORLANDO, FL 32819 | - |
| REGISTERED AGENT NAME CHANGED | 2014-11-18 | CT CORPORATION SYSTEM | - |
| REGISTERED AGENT ADDRESS CHANGED | 2014-11-18 | 1200 S PINE ISLAND RD, PLANTATION, FL 33324 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-04-25 |
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-04-28 |
| ANNUAL REPORT | 2019-04-02 |
| ANNUAL REPORT | 2018-04-02 |
| ANNUAL REPORT | 2017-04-13 |
| ANNUAL REPORT | 2016-04-05 |
| ANNUAL REPORT | 2015-04-11 |
Date of last update: 01 Apr 2025
Sources: Florida Department of State
