Search icon

TITUSVILLE PHARMACY, LLC

Company Details

Entity Name: TITUSVILLE PHARMACY, LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Company
Status: Active
Date Filed: 12 Nov 2010 (14 years ago)
Document Number: L10000117882
FEI/EIN Number 80-0661578
Address: 2175 CHENEY HWY, STE B, TITUSVILLE, FL 32780
Mail Address: 2175 CHENEY HWY, SUITE B, TITUSVILLE, FL 32780
ZIP code: 32780
County: Brevard
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1073800579 2011-07-05 2014-11-21 2175 CHENEY HWY STE B, TITUSVILLE, FL, 327806792, US 2175 CHENEY HWY STE B, TITUSVILLE, FL, 327806792, US

Contacts

Phone +1 321-268-0911
Fax 3212680918

Authorized person

Name ARVINDBHAI PATEL
Role OWNER
Phone 4074886851

Taxonomy

Taxonomy Code 333600000X - Pharmacy
Is Primary No
Taxonomy Code 3336C0003X - Community/Retail Pharmacy
License Number PH25543
State FL
Is Primary Yes
Taxonomy Code 3336C0004X - Compounding Pharmacy
Is Primary No

Other Provider Identifiers

Issuer MEDICAID
Number 004155200
State FL
Issuer PK
Number 2131551
Issuer MEDICAID
Number 004155201
State FL

Agent

Name Role Address
PATEL, PRAGNESH Agent 2175 CHENEY HWY, SUITE B, TITUSVILLE, FL 32780

Manager

Name Role Address
PATEL, PRAGNESH Manager 2175 CHENEY HWY, SUITE B, TITUSVILLE, FL 32780
Shah, Ronak Manager 2808 Wyndham Way, Melbourne, FL 32940
Patel, Mital Manager 10854 Lago Bella Drive, Orlando, FL 32832
Patel, Narendra Manager 13358 Alderley Drive, Orlando, FL 32832

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G18000078756 TITUSVILLE DISCOUNT PHARMACY ACTIVE 2018-07-20 2028-12-31 No data 2175 CHENEY HIGHWAY, SUITE B, TITUSVILLE, FL, 32780
G10000105073 TITUSVILLE DISCOUNT PHARMACY EXPIRED 2010-11-16 2015-12-31 No data 6801 NORTH US HWY 1, SUITE 1, COCOA, FL, 32927

Events

Event Type Filed Date Value Description
CHANGE OF MAILING ADDRESS 2013-01-28 2175 CHENEY HWY, STE B, TITUSVILLE, FL 32780 No data
REGISTERED AGENT ADDRESS CHANGED 2013-01-28 2175 CHENEY HWY, SUITE B, TITUSVILLE, FL 32780 No data
CHANGE OF PRINCIPAL ADDRESS 2012-02-12 2175 CHENEY HWY, STE B, TITUSVILLE, FL 32780 No data

Documents

Name Date
ANNUAL REPORT 2024-04-08
AMENDED ANNUAL REPORT 2023-11-08
ANNUAL REPORT 2023-03-02
ANNUAL REPORT 2022-03-11
ANNUAL REPORT 2021-04-01
AMENDED ANNUAL REPORT 2020-08-13
ANNUAL REPORT 2020-02-03
ANNUAL REPORT 2019-02-12
ANNUAL REPORT 2018-02-22
ANNUAL REPORT 2017-02-24

Date of last update: 24 Jan 2025

Sources: Florida Department of State