Entity Name: | SA DRUGS LLC |
Jurisdiction: | FLORIDA |
Filing Type: | Florida Limited Liability Company |
Status: | Inactive |
Date Filed: | 22 Sep 2011 (13 years ago) |
Date of dissolution: | 03 Apr 2016 (9 years ago) |
Last Event: | VOLUNTARY DISSOLUTION |
Event Date Filed: | 03 Apr 2016 (9 years ago) |
Document Number: | L11000108614 |
FEI/EIN Number | 45-3357842 |
Address: | 115 NW SANTA FE BLVD, HIGH SPRINGS, FL 32643 |
Mail Address: | 115 NW SANTA FE BLVD, HIGH SPRINGS, FL 32643 |
ZIP code: | 32643 |
County: | Alachua |
Place of Formation: | FLORIDA |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1750654711 | 2012-02-21 | 2013-03-13 | 13207 THOMASVILLE CIR APT D, TAMPA, FL, 336179507, US | 115 NW SANTA FE BLVD, HIGH SPRINGS, FL, 326434301, US | |||||||||||||||||||||||||||||||||||||||
|
Phone | +1 386-454-7768 |
Authorized person
Name | RAJASEKARAN MANI |
Role | MANAGER |
Phone | 2392460796 |
Taxonomy
Taxonomy Code | 333600000X - Pharmacy |
Is Primary | No |
Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
License Number | PH25943 |
State | FL |
Is Primary | Yes |
Taxonomy Code | 3336C0004X - Compounding Pharmacy |
Is Primary | No |
Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
Is Primary | No |
Other Provider Identifiers
Issuer | MEDICAID |
Number | 005462300 |
State | FL |
Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
Number | 5709172 |
Name | Role | Address |
---|---|---|
MANI, RAJASEKARAN | Agent | 115 NW SANTA FE BLVD, HIGH SPRINGS, FL 32643 |
Name | Role | Address |
---|---|---|
MANI, RAJASEKARAN | Managing Member | 115 NW SANTA FE BLVD, HIGH SPRINGS, FL 32643 |
Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
---|---|---|---|---|---|---|
G11000101184 | CITY DRUGS | EXPIRED | 2011-10-13 | 2016-12-31 | No data | 115 NW SANTA FE BLVD, HIGH SPRINGS, FL, 32643 |
Event Type | Filed Date | Value | Description |
---|---|---|---|
VOLUNTARY DISSOLUTION | 2016-04-03 | No data | No data |
REGISTERED AGENT ADDRESS CHANGED | 2014-03-09 | 115 NW SANTA FE BLVD, HIGH SPRINGS, FL 32643 | No data |
CHANGE OF PRINCIPAL ADDRESS | 2012-04-05 | 115 NW SANTA FE BLVD, HIGH SPRINGS, FL 32643 | No data |
CHANGE OF MAILING ADDRESS | 2012-04-05 | 115 NW SANTA FE BLVD, HIGH SPRINGS, FL 32643 | No data |
Name | Date |
---|---|
VOLUNTARY DISSOLUTION | 2016-04-03 |
ANNUAL REPORT | 2015-04-03 |
ANNUAL REPORT | 2014-03-09 |
ANNUAL REPORT | 2013-03-30 |
ANNUAL REPORT | 2012-04-05 |
Florida Limited Liability | 2011-09-22 |
Date of last update: 24 Jan 2025
Sources: Florida Department of State