| Entity Name: | RX CARE OF TAMPA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 04 Jun 2010 (15 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 20 Oct 2022 (2 years ago) |
| Document Number: | L10000060088 |
| FEI/EIN Number | 272124268 |
| Address: | 2235 Central Ave. Suite A, ST PETERSBURG, FL, 33713, US |
| Mail Address: | 701 94th Ave. N., ST PETERSBURG, FL, 33702, US |
| ZIP code: | 33713 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1174829352 | 2011-02-04 | 2024-03-05 | 701 94TH AVE N STE 250, ST PETERSBURG, FL, 337022448, US | 2235 CENTRAL AVE STE A, ST PETERSBURG, FL, 337138844, US | |||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 727-321-3854 |
| Fax | 7277484277 |
| Phone | +1 813-249-6593 |
Authorized person
| Name | RAJWANTIE RAJKUMAR |
| Role | CHIEF EXECUTIVE OFFICER |
| Phone | 7273213854 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | Yes |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH24764 |
| State | FL |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID DME |
| Number | 003254201 |
| State | FL |
| Issuer | MEDICAID |
| Number | 003254201 |
| State | FL |
| Issuer | PK |
| Number | 2128291 |
| Issuer | MEDICAID |
| Number | 003254200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SPARKS BRENT | Agent | 701 94th Ave. N., ST PETERSBURG, FL, 33702 |
| Name | Role | Address |
|---|---|---|
| Rajkumar Rajwantie P | Manager | 701 94th Ave. N., ST PETERSBURG, FL, 33702 |
| Name | Role | Address |
|---|---|---|
| Sparks Brent | Assi | 701 94th Ave. N., ST PETERSBURG, FL, 33702 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000091911 | METRO INCLUSIVE PHARMACY, LLC | ACTIVE | 2023-08-07 | 2028-12-31 | No data | 2235 CENTRAL AVE. SUITE A, ST PETERSBURG, FL, 33713 |
| G23000018459 | NEW WATERS PHARMACY | ACTIVE | 2023-02-08 | 2028-12-31 | No data | 2235 CENTRAL AVE SUITE A, ST.PETERSBURG, FL, 33713 |
| G22000118574 | NEW WATERS PHARMACY | ACTIVE | 2022-09-20 | 2027-12-31 | No data | 4311 W WATERS AVE STE#590, TAMPA, FL, 33614 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT ADDRESS CHANGED | 2024-01-19 | 701 94th Ave. N., Suite 250, ST PETERSBURG, FL 33702 | No data |
| CHANGE OF MAILING ADDRESS | 2024-01-19 | 2235 Central Ave. Suite A, ST PETERSBURG, FL 33713 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2023-05-30 | 2235 Central Ave. Suite A, ST PETERSBURG, FL 33713 | No data |
| REGISTERED AGENT NAME CHANGED | 2023-01-30 | SPARKS, BRENT | No data |
| LC AMENDMENT | 2022-10-20 | No data | No data |
| REINSTATEMENT | 2017-10-18 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2017-09-22 | No data | No data |
| REINSTATEMENT | 2016-02-22 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-07 |
| ANNUAL REPORT | 2024-01-19 |
| AMENDED ANNUAL REPORT | 2023-12-04 |
| ANNUAL REPORT | 2023-01-30 |
| LC Amendment | 2022-10-20 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-01-28 |
| ANNUAL REPORT | 2020-06-29 |
| ANNUAL REPORT | 2019-02-07 |
| ANNUAL REPORT | 2018-03-02 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
