| Entity Name: | TITUSVILLE PHARMACY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
TITUSVILLE PHARMACY, LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 12 Nov 2010 (14 years ago) |
| Document Number: | L10000117882 |
| FEI/EIN Number |
800661578
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 2175 CHENEY HWY, STE B, TITUSVILLE, FL, 32780, US |
| Mail Address: | 2175 CHENEY HWY, SUITE B, TITUSVILLE, FL, 32780, US |
| ZIP code: | 32780 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| 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 | |||||||||||||||||||||||||||||||||||||||||||
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| 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 |
| 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 |
| PATEL PRAGNESH | Agent | 2175 CHENEY HWY, TITUSVILLE, FL, 32780 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G18000078756 | TITUSVILLE DISCOUNT PHARMACY | ACTIVE | 2018-07-20 | 2028-12-31 | - | 2175 CHENEY HIGHWAY, SUITE B, TITUSVILLE, FL, 32780 |
| G10000105073 | TITUSVILLE DISCOUNT PHARMACY | EXPIRED | 2010-11-16 | 2015-12-31 | - | 6801 NORTH US HWY 1, SUITE 1, COCOA, FL, 32927 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2013-01-28 | 2175 CHENEY HWY, STE B, TITUSVILLE, FL 32780 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2013-01-28 | 2175 CHENEY HWY, SUITE B, TITUSVILLE, FL 32780 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2012-02-12 | 2175 CHENEY HWY, STE B, TITUSVILLE, FL 32780 | - |
| 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 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1482448000 | 2020-06-22 | 0455 | PPP | 2175 CHENEY HWY STE B, TITUSVILLE, FL, 32780-6701 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 01 Apr 2025
Sources: Florida Department of State
