| Entity Name: | LEWIS PHARMACY OF PALM BEACH, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 25 Apr 2006 (19 years ago) |
| Document Number: | L06000042814 |
| FEI/EIN Number | 270144785 |
| Mail Address: | 235 SOUTH COUNTY ROAD, PALM BEACH, FL, 33480 |
| Address: | 235 SOUTH COUNTY ROAD, 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 | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1437363389 | 2007-05-10 | 2011-03-11 | PO BOX 9830, SALT LAKE CITY, UT, 841099830, US | 235 S COUNTY RD, PALM BEACH, FL, 334804294, US | |||||||||||||||||||||||||||||||
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| Phone | +1 877-540-4748 |
| Fax | 8017164872 |
| Phone | +1 561-655-7867 |
| Fax | 5618321240 |
Authorized person
| Name | MIPAL PATEL |
| Role | PHARMACIST OWNER |
| Phone | 5616557867 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH22226 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 1073496 |
| Name | Role | Address |
|---|---|---|
| PATEL MIPAL J | Agent | 235 SOUTH COUNTY ROAD, PALM BEACH, FL, 33480 |
| Name | Role | Address |
|---|---|---|
| PATEL MIPAL J | Managing Member | 235 SOUTH COUNTY ROAD, PALM BEACH, FL, 33480 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2012-02-09 | 235 SOUTH COUNTY ROAD, PALM BEACH, FL 33480 UN | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| 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 |
| ANNUAL REPORT | 2018-02-09 |
| ANNUAL REPORT | 2017-02-14 |
| ANNUAL REPORT | 2016-03-09 |
| ANNUAL REPORT | 2015-02-27 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
