| Entity Name: | THE PHARMACY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 08 Jun 2011 (14 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 15 Aug 2016 (8 years ago) |
| Document Number: | L11000066915 |
| FEI/EIN Number | 45-5309702 |
| Address: | 333 South Plumosa Street, Merritt Island, FL, 32952, US |
| Mail Address: | 333 SOUTH PLUMOSA STREET, MERRITT ISLAND, FL, 32952, US |
| ZIP code: | 32952 |
| County: | Brevard |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1679822365 | 2012-09-10 | 2021-05-14 | 333 SOUTH PLUMOSA STREET, MERRITT ISLAND, FL, 329524891, US | 333 SOUTH PLUMOSA STREET, MERRITT ISLAND, FL, 329524891, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 321-208-8999 |
| Fax | 8448374163 |
Authorized person
| Name | ROSS CLARK |
| Role | PHARMACIST/OWNER |
| Phone | 3212088999 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH26255 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | PK |
| Number | 2136915 |
| Issuer | MEDICAID |
| Number | 015628300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| CLARK ROSS | Agent | 1803 North Indian River Drive, Cocoa, FL, 32922 |
| Name | Role | Address |
|---|---|---|
| CLARK ROSS | Owne | 1803 NORTH INDIAN RIVER DRIVE, COCOA, FL, 32922 |
| Name | Role | Address |
|---|---|---|
| Goudelock Margaret | Busi | 333 South Plumosa Street, Merritt Island, FL, 32952 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-04-01 | 333 South Plumosa Street, Merritt Island, FL 32952 | No data |
| CHANGE OF MAILING ADDRESS | 2021-04-01 | 333 South Plumosa Street, Merritt Island, FL 32952 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-04-01 | 1803 North Indian River Drive, Cocoa, FL 32922 | No data |
| LC STMNT OF RA/RO CHG | 2016-08-15 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2016-08-15 | CLARK, ROSS | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-09 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-01-11 |
| ANNUAL REPORT | 2021-04-01 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-02-11 |
| ANNUAL REPORT | 2018-03-10 |
| ANNUAL REPORT | 2017-02-07 |
| CORLCRACHG | 2016-08-15 |
| ANNUAL REPORT | 2016-04-21 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
