| Entity Name: | ARRIVA MEDICAL, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 17 Mar 2008 (17 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 10 Mar 2022 (3 years ago) |
| Document Number: | L08000027490 |
| FEI/EIN Number | 26-2193963 |
| Address: | 100 Abbott Park Road, D367 AP6D (Sales Tax), Abbott Park, IL, 60064, US |
| Mail Address: | 100 Abbott Park Road, D367 AP6D (Sales Tax), Abbott Park, IL, 60064, US |
| Place of Formation: | FLORIDA |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | ARRIVA MEDICAL, LLC, MISSISSIPPI | 1022834 | MISSISSIPPI |
| Headquarter of | ARRIVA MEDICAL, LLC, ALABAMA | 000-299-261 | ALABAMA |
| Headquarter of | ARRIVA MEDICAL, LLC, KENTUCKY | 0870969 | KENTUCKY |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1659821437 | 2016-10-05 | 2016-10-05 | 310 EAGLES LANDING DR, LAKELAND, FL, 338102999, US | 310 EAGLES LANDING DR, LAKELAND, FL, 338102999, US | |||||||||||||||||||||||||||
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| Phone | +1 866-336-4103 |
| Fax | 8772230483 |
Authorized person
| Name | TOM WALTERS |
| Role | OPERATIONS VP |
| Phone | 8007004442 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH27239 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2164270 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SPIN-OFF TERMINATION PLAN FOR ARRIVA MEDICAL, LLC | 2020 | 262193963 | 2021-09-14 | ARRIVA MEDICAL, LLC | 33 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2021-09-14 |
| Name of individual signing | ASHLEY WALKER |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 561300 |
| Sponsor’s telephone number | 9549053443 |
| Plan sponsor’s address | 4252 NW 120TH AVE, CORAL SPRINGS, FL, 33065 |
Signature of
| Role | Plan administrator |
| Date | 2020-08-31 |
| Name of individual signing | CARLY FORLINES |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2018-01-01 |
| Business code | 561300 |
| Sponsor’s telephone number | 9549053443 |
| Plan sponsor’s address | 4252 NW 120TH AVE, CORAL SPRINGS, FL, 33065 |
Signature of
| Role | Plan administrator |
| Date | 2019-08-27 |
| Name of individual signing | PANDOREL WILLIAMS |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| CT CORPORATION SYSTEM | Agent | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL, 33324 |
| Name | Role | Address |
|---|---|---|
| Kaesebier Tara R | Asst | 100 Abbott Park Road, Abbott Park, IL, 60064 |
| Name | Role | Address |
|---|---|---|
| Davies Alison E | Manager | 100 Abbott Park Road, Abbott Park, IL, 60064 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G14000030086 | ARRIVA PHARMACY | EXPIRED | 2014-03-25 | 2019-12-31 | No data | 4252 NW 120 AVE, ATTN: JESSICA ROBINSON, CORAL SPRINGS, FL, 33065 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-16 | 100 Abbott Park Road, D367 AP6D (Sales Tax), Abbott Park, IL 60064 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-16 | 100 Abbott Park Road, D367 AP6D (Sales Tax), Abbott Park, IL 60064 | No data |
| REGISTERED AGENT NAME CHANGED | 2022-03-10 | CT CORPORATION SYSTEM | No data |
| REINSTATEMENT | 2022-03-10 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-10-11 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | No data |
| LC STMNT OF RA/RO CHG | 2017-10-11 | No data | No data |
| CANCEL ADM DISS/REV | 2009-10-15 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2009-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-16 |
| ANNUAL REPORT | 2023-02-24 |
| REINSTATEMENT | 2022-03-10 |
| ANNUAL REPORT | 2020-03-20 |
| ANNUAL REPORT | 2019-05-10 |
| ANNUAL REPORT | 2018-05-09 |
| CORLCRACHG | 2017-10-11 |
| ANNUAL REPORT | 2017-03-01 |
| AMENDED ANNUAL REPORT | 2016-07-08 |
| ANNUAL REPORT | 2016-04-12 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
