| Entity Name: | MED 1ST, L.L.C. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Inactive |
| Date Filed: | 22 Oct 2004 (20 years ago) |
| Date of dissolution: | 16 Apr 2014 (11 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 16 Apr 2014 (11 years ago) |
| Document Number: | L04000077236 |
| FEI/EIN Number | 42-1681796 |
| Address: | 1408 N Dale Mabry Hwy Ste 115, Lutz, FL 33548 |
| Mail Address: | 1408 N Dale Mabry Hwy Ste 115, Lutz, FL 33548 |
| ZIP code: | 33548 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174645477 | 2007-04-06 | 2009-08-31 | 11206 CHALLENGER AVE, UNIT D, ODESSA, FL, 335563482, US | 11206 CHALLENGER AVE, UNIT D, ODESSA, FL, 335563482, US | |||||||||||||||||||||||||||
|
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| Phone | +1 727-375-9898 |
| Fax | 7273759870 |
Authorized person
| Name | TERENCE WILLIAMS |
| Role | CO OWNER |
| Phone | 7273759898 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336M0003X - Managed Care Organization Pharmacy |
| License Number | PH22474 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 1025370 |
| Name | Role | Address |
|---|---|---|
| WILLIAMS, TERENCE | Agent | 1408 DALE MABRY HWY STE 115, LUTZ, FL 33548 |
| Name | Role | Address |
|---|---|---|
| WILLIAMS, TERENCE | Managing Member | 3959 Van Dyke Rd, 275 LUTZ, FL 33558 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2014-04-16 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2013-04-17 | 1408 N Dale Mabry Hwy Ste 115, Lutz, FL 33548 | No data |
| CHANGE OF MAILING ADDRESS | 2013-04-17 | 1408 N Dale Mabry Hwy Ste 115, Lutz, FL 33548 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-04-30 | 1408 DALE MABRY HWY STE 115, LUTZ, FL 33548 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-04-17 |
| ANNUAL REPORT | 2012-04-30 |
| ANNUAL REPORT | 2011-04-26 |
| ANNUAL REPORT | 2010-03-30 |
| ANNUAL REPORT | 2009-03-19 |
| ANNUAL REPORT | 2008-06-09 |
| Off/Dir Resignation | 2007-05-31 |
| ANNUAL REPORT | 2007-05-16 |
| ANNUAL REPORT | 2006-04-17 |
| ANNUAL REPORT | 2005-02-10 |
Date of last update: 29 Jan 2025
Sources: Florida Department of State
