| Entity Name: | ALLEN MEDICAL SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 21 Jul 1989 (36 years ago) |
| Document Number: | L03550 |
| FEI/EIN Number | 592962913 |
| Address: | 6953 GALL BLVD., ZEPHYRHILLS, FL, 33542 |
| Mail Address: | 6953 GALL BLVD., ZEPHYRHILLS, FL, 33542 |
| ZIP code: | 33542 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174600902 | 2006-11-01 | 2022-03-22 | 6953 GALL BLVD, ZEPHYRHILLS, FL, 33542, US | 6953 GALL BLVD, ZEPHYRHILLS, FL, 33542, US | |||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 813-788-7885 |
| Fax | 8137880950 |
Authorized person
| Name | MRS. EVELYN L ALLEN JOHNSON |
| Role | PHARMACIST MANAGER |
| Phone | 8137887885 |
Taxonomy
| Taxonomy Code | 183500000X - Pharmacist |
| License Number | PH20846 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | PH10896 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | NABP # |
| Number | 1063471 |
| State | FL |
| Issuer | MEDICAID |
| Number | 100750500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Patel Harit Preside | Agent | 16740 carravaggio loop, montverde, FL, 34756 |
| Name | Role | Address |
|---|---|---|
| Patel Haritkumar C | owne | 16740 carrvaggio loop, montverde, FL, 34756 |
| Name | Role | Address |
|---|---|---|
| Patel Shruti | offi | 11050 Autumn lane, Clermont, FL, 34711 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G03253900272 | X-TRA DISCOUNT DRUGS | ACTIVE | 2003-09-10 | 2028-12-31 | No data | 6953 GALL BLVD, ZEPHYRHILLS, FL, 33542--258 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2022-01-18 | No data | No data |
| REINSTATEMENT | 1998-03-13 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1996-08-23 | No data | No data |
| REINSTATEMENT | 1995-11-16 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1995-08-25 | No data | No data |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
