| Entity Name: | A CHEM RX, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 16 Mar 2010 (15 years ago) |
| Document Number: | L10000028858 |
| FEI/EIN Number | 272122413 |
| Address: | 12116 CORTEZ BLVD, BROOKSVILLE, FL, 34613, US |
| Mail Address: | 12116 CORTEZ BLVD, BROOKSVILLE, FL, 34613, US |
| ZIP code: | 34613 |
| County: | Hernando |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1356356901 | 2006-07-30 | 2016-07-21 | 12116 CORTEZ BLVD, BROOKSVILLE, FL, 346135514, US | 12116 CORTEZ BLVD, BROOKSVILLE, FL, 346135514, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 352-592-1320 |
| Fax | 3525921321 |
Authorized person
| Name | ANISH CHEMPARATHY |
| Role | OWNER/MANAGER |
| Phone | 3525921320 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH24622 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2124531 |
| Issuer | MEDICAID |
| Number | 002127800 |
| State | FL |
| Name | Role |
|---|---|
| AMERICAN SAFETY COUNCIL, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| CHEMPARATHY ANISH | Manager | 12116 CORTEZ BLVD, BROOKSVILLE, FL, 34613 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G10000025297 | CORTEZ DRUGS | ACTIVE | 2010-03-18 | 2025-12-31 | No data | 12116 CORTEZ BLVD, BROOKSVILLE, FL, 34613 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-14 |
| ANNUAL REPORT | 2024-01-16 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-02-07 |
| ANNUAL REPORT | 2021-01-05 |
| ANNUAL REPORT | 2020-01-10 |
| ANNUAL REPORT | 2019-02-06 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-02-13 |
| ANNUAL REPORT | 2016-01-22 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
