| Entity Name: | SHREY PHARMACY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 28 Jun 2010 (15 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 09 Nov 2020 (4 years ago) |
| Document Number: | L10000068654 |
| FEI/EIN Number | 272940073 |
| Address: | 19107 HARBOR COVE CT, LUTZ, FL, 33558, US |
| Mail Address: | 19107 HARBOR COVE CT, LUTZ, FL, 33558, US |
| ZIP code: | 33558 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1306147319 | 2010-11-07 | 2023-04-21 | 19107 HARBOR COVE CT, LUTZ, FL, 335589702, US | 5340 SPRING HILL DR, SPRING HILL, FL, 346064562, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 813-454-3500 |
| Fax | 3526104349 |
| Phone | +1 352-610-4437 |
| Fax | 3526104427 |
Authorized person
| Name | MR. GAUTAM THAKKAR |
| Role | PHARMACY MANAGER |
| Phone | 8134543500 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH25021 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 003329000 |
| State | FL |
| Name | Role |
|---|---|
| MASSEY LAW GROUP, P.A. | Agent |
| Name | Role |
|---|---|
| RAGSHIP LLC | Manager |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000109503 | PINE BROOK PHARMACY | ACTIVE | 2021-08-24 | 2026-12-31 | No data | 19107 HARBOR COVE CT, LUTZ, FL, LUTZ, FL, 33558 |
| G18000055569 | PINE BROOK PHARMACY | ACTIVE | 2018-05-04 | 2028-12-31 | No data | 19107 HARBOR COVE CT, LUTZ, FL, 33558 |
| G10000080393 | PINE BROOK PHARMACY | EXPIRED | 2010-09-01 | 2015-12-31 | No data | 19107 HARBOR COVE CT, LUTZ, FL, 33558 |
| G10000065443 | SPRING HILL PHARMACY | EXPIRED | 2010-07-15 | 2015-12-31 | No data | 19107 HARBOR COVE CT, LUTZ, FL, 33558 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2020-11-09 | No data | No data |
| LC STMNT OF RA/RO CHG | 2020-08-21 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-08-21 | MASSEY LAW GROUP, P.A. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-08-21 | 76 4TH STREET, 262, ST PETERSBURG, FL 33731 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-18 |
| ANNUAL REPORT | 2023-02-28 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-01-06 |
| LC Amendment | 2020-11-09 |
| CORLCRACHG | 2020-08-21 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-02-04 |
| ANNUAL REPORT | 2018-02-19 |
| ANNUAL REPORT | 2017-01-12 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
