| Entity Name: | SOUTH WALTON PHARMACY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
SOUTH WALTON 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: | 18 Mar 2011 (14 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 15 Dec 2022 (2 years ago) |
| Document Number: | L11000033039 |
| FEI/EIN Number |
450907542
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 2050 West County Hwy 30A, SANTA ROSA BEACH, FL, 32459, US |
| Mail Address: | 2050 West County Hwy 30A, SANTA ROSA BEACH, FL, 32459, US |
| ZIP code: | 32459 |
| County: | Walton |
| Place of Formation: | FLORIDA |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | SOUTH WALTON PHARMACY LLC, ALASKA | 10268674 | ALASKA |
| Headquarter of | SOUTH WALTON PHARMACY LLC, ALABAMA | 000-953-482 | ALABAMA |
| Headquarter of | SOUTH WALTON PHARMACY LLC, NEW YORK | 7456772 | NEW YORK |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1942509401 | 2011-03-23 | 2023-05-05 | 2050 W COUNTY HIGHWAY 30A, M1-106, SANTA ROSA BEACH, FL, 324590187, US | 2050 W COUNTY HIGHWAY 30A UNIT M1-106, SANTA ROSA BEACH, FL, 324590187, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 850-622-3313 |
| Fax | 8506223255 |
Authorized person
| Name | HAROLD E CANNON |
| Role | SOLE MEMBER |
| Phone | 8506223313 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH25428 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336H0001X - Home Infusion Therapy Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336S0011X - Specialty Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 117267300 |
| State | FL |
| Issuer | PK |
| Number | 2130225 |
| Name | Role | Address |
|---|---|---|
| CANNON HAROLD | Authorized Person | 2050 WEST COUNTY HWY 30A, SANTA ROSA BEACH, FL, 32459 |
| BUSINESS FILINGS INCORPORATED | Agent | - |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G11000034448 | SANTA ROSA PHARMACY | ACTIVE | 2011-04-06 | 2026-12-31 | - | 2050 W COUNTY HIGHWAY 30A STE 106, SANTA ROSA BEACH, FL, 32459 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2022-12-15 | - | - |
| CHANGE OF MAILING ADDRESS | 2022-01-11 | 2050 West County Hwy 30A, Unit M1-106, SANTA ROSA BEACH, FL 32459 | - |
| LC AMENDMENT | 2021-06-15 | - | - |
| REGISTERED AGENT NAME CHANGED | 2021-06-15 | BUSINESS FILINGS INCORPORATED | - |
| REGISTERED AGENT ADDRESS CHANGED | 2021-06-15 | 1200 SOUTH PINE ISLAND ROAD, PLANTATION, FL 33324 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2017-02-12 | 2050 West County Hwy 30A, Unit M1-106, SANTA ROSA BEACH, FL 32459 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-08 |
| ANNUAL REPORT | 2024-01-05 |
| ANNUAL REPORT | 2023-01-12 |
| LC Amendment | 2022-12-15 |
| ANNUAL REPORT | 2022-01-11 |
| LC Amendment | 2021-06-15 |
| ANNUAL REPORT | 2021-02-02 |
| ANNUAL REPORT | 2020-01-18 |
| ANNUAL REPORT | 2019-03-31 |
| ANNUAL REPORT | 2018-03-25 |
| FAIN | Awarding Agency | Assistance Listings | Start Date | End Date | Description | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 4646525002 | Small Business Administration | 59.012 - 7(A) LOAN GUARANTEES | - | - | TO AID SMALL BUSINESSES WHICH ARE UNABLE TO OBTAIN FINANCING IN THE PRIVATE CREDIT MARKETPLACE | |||||||||||||||||
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| 4620695009 | Small Business Administration | 59.012 - 7(A) LOAN GUARANTEES | - | - | TO AID SMALL BUSINESSES WHICH ARE UNABLE TO OBTAIN FINANCING IN THE PRIVATE CREDIT MARKETPLACE | |||||||||||||||||
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| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 2935647101 | 2020-04-11 | 0491 | PPP | 2050 COUNTY HIGHWAY 30A M1-106, SANTA ROSA BEACH, FL, 32459-0187 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 03 Apr 2025
Sources: Florida Department of State
