| Entity Name: | SEASIDE FAMILY PHARMACY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
SEASIDE FAMILY PHARMACY, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Inactive
The business entity is inactive. This status may signal operational issues or voluntary closure, raising concerns about the business's ability to repay loans and requiring careful risk assessment by lenders. |
| Date Filed: | 23 Jan 2006 (19 years ago) |
| Date of dissolution: | 26 Sep 2014 (11 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 26 Sep 2014 (11 years ago) |
| Document Number: | L06000007984 |
| FEI/EIN Number |
030579462
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | c/o Island Family Pharmacy, 600 Plantation Island Dr. S., ST. AUGUSTINE, FL, 32080, US |
| Mail Address: | c/o Island Family Pharmacy, 600 Plantation Island Dr. S., ST. AUGUSTINE, FL, 32080, US |
| ZIP code: | 32080 |
| County: | St. Johns |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245283423 | 2006-05-18 | 2012-02-06 | 4075 A1A S, STE 102, ST AUGUSTINE, FL, 320806773, US | 4075 A1A S, STE 102, ST AUGUSTINE, FL, 320806773, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 904-461-3299 |
| Fax | 9044613277 |
Authorized person
| Name | JAMES PENNINGTON |
| Role | CO OWNER |
| Phone | 9044613299 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH21889 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 031351200 |
| State | FL |
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 1018301 |
| Name | Role | Address |
|---|---|---|
| BLANCO RYAN | Manager | 3485 KINGS RD. S., ST AUGUSTINE, FL, 32086 |
| MCCARTY ANTHONY O | Manager | 4112 CREEK BLUFF DR, ST AUGUSTINE, FL, 32086 |
| PENNINGTON JAMES D | Agent | 115 SAN RAFAEL RD., ST. AUGUSTINE, FL, 32080 |
| PENNINGTON JAMES DENNIS | Manager | 4075 A1A SOUTH, SUITE 102, ST. AUGUSTINE, FL, 32080 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2014-09-26 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2013-02-09 | c/o Island Family Pharmacy, 600 Plantation Island Dr. S., Unit 3, ST. AUGUSTINE, FL 32080 | - |
| CHANGE OF MAILING ADDRESS | 2013-02-09 | c/o Island Family Pharmacy, 600 Plantation Island Dr. S., Unit 3, ST. AUGUSTINE, FL 32080 | - |
| REGISTERED AGENT NAME CHANGED | 2008-04-09 | PENNINGTON, JAMES DMANAGER | - |
| REGISTERED AGENT ADDRESS CHANGED | 2008-04-09 | 115 SAN RAFAEL RD., ST. AUGUSTINE, FL 32080 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2013-02-09 |
| ANNUAL REPORT | 2012-03-11 |
| ANNUAL REPORT | 2011-03-06 |
| ANNUAL REPORT | 2010-02-16 |
| ANNUAL REPORT | 2009-02-18 |
| ANNUAL REPORT | 2008-04-09 |
| ANNUAL REPORT | 2007-01-05 |
| Florida Limited Liability | 2006-01-23 |
Date of last update: 02 Apr 2025
Sources: Florida Department of State
