| Entity Name: | JET PHARMACY LLC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 11 Feb 2009 (16 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | L09000013939 |
| FEI/EIN Number | 264306890 |
| Address: | 2310 W WATERS AVE STE J, TAMPA, FL, 33604 |
| Mail Address: | 2310 W WATERS AVE STE J, TAMPA, FL, 33604 |
| ZIP code: | 33604 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1003048950 | 2009-08-11 | 2015-09-15 | 2310 W WATERS AVE, STE J, TAMPA, FL, 336042764, US | 2310 W WATERS AVE, STE J, TAMPA, FL, 336042764, US | |||||||||||||||||||||||||||||
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| Phone | +1 813-933-3458 |
| Fax | 8139355163 |
Authorized person
| Name | CHARLES SMITH |
| Role | RPH |
| Phone | 8139333458 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH24178 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2121317 |
| Issuer | MEDICAID |
| Number | 001437200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| ANADIUME VICTOR | Agent | 2310 W WATERS AVE STE J, TAMPA, FL, 33604 |
| Name | Role | Address |
|---|---|---|
| OBI-ANADIUME VICTOR | Manager | 2310 W WATERS AVE STE J, TAMPA, FL, 33604 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| LC AMENDMENT | 2013-10-15 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2012-03-12 | 2310 W WATERS AVE STE J, TAMPA, FL 33604 | No data |
| CHANGE OF MAILING ADDRESS | 2012-03-12 | 2310 W WATERS AVE STE J, TAMPA, FL 33604 | No data |
| REGISTERED AGENT NAME CHANGED | 2012-03-12 | ANADIUME, VICTOR | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2012-03-12 | 2310 W WATERS AVE STE J, TAMPA, FL 33604 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2018-03-27 |
| ANNUAL REPORT | 2017-02-17 |
| ANNUAL REPORT | 2016-04-28 |
| ANNUAL REPORT | 2015-01-20 |
| ANNUAL REPORT | 2014-01-30 |
| LC Amendment | 2013-10-15 |
| ANNUAL REPORT | 2013-01-30 |
| ANNUAL REPORT | 2012-03-12 |
| ANNUAL REPORT | 2011-03-17 |
| ANNUAL REPORT | 2010-04-26 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
