| Entity Name: | SUDDHA PHARMACY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 20 Apr 2005 (20 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 26 Nov 2007 (17 years ago) |
| Document Number: | L05000038611 |
| FEI/EIN Number | 202524259 |
| Address: | 255 SUNRISE AVE, PALM BEACH, FL, 33480, UN |
| Mail Address: | 255 SUNRISE AVE, PALM BEACH, FL, 33480, UN |
| ZIP code: | 33480 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972841229 | 2013-01-22 | 2013-01-22 | 255 SUNRISE AVE, PALM BEACH, FL, 334803876, US | 255 SUNRISE AVE, PALM BEACH, FL, 334803876, US | |||||||||||||||||||||||||||||
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| Phone | +1 561-659-6713 |
Authorized person
| Name | AMAR PATEL |
| Role | MANAGER |
| Phone | 5616596713 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| License Number | PH21413 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 5713121 |
| Name | Role | Address |
|---|---|---|
| PATEL DIPTI | Agent | 255 SUNRISE AVE, PALM BEACH, FL, 33480 |
| Name | Role | Address |
|---|---|---|
| PATEL DIPTI | Manager | 255 SUNRISE AVE, PALM BEACH, FL, 33480 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000075074 | FEDCO DRUGS | EXPIRED | 2016-07-27 | 2021-12-31 | No data | 255 SUNRISE AVE, PALM BEACH, FL, 33480 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-01-31 | PATEL, DIPTI | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-02-09 | 255 SUNRISE AVE, PALM BEACH, FL 33480 UN | No data |
| CHANGE OF MAILING ADDRESS | 2012-02-09 | 255 SUNRISE AVE, PALM BEACH, FL 33480 UN | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2008-01-05 | 255 SUNRISE AVE, PALM BEACH, FL 33480 | No data |
| REINSTATEMENT | 2007-11-26 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-31 |
| ANNUAL REPORT | 2023-04-17 |
| ANNUAL REPORT | 2022-02-23 |
| ANNUAL REPORT | 2021-02-22 |
| ANNUAL REPORT | 2020-01-24 |
| ANNUAL REPORT | 2019-02-07 |
| AMENDED ANNUAL REPORT | 2018-09-13 |
| ANNUAL REPORT | 2018-02-09 |
| ANNUAL REPORT | 2017-02-14 |
| ANNUAL REPORT | 2016-03-09 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
