| Entity Name: | FATHER DAVID, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 19 Oct 2011 (13 years ago) |
| Document Number: | L11000119630 |
| FEI/EIN Number | 453642413 |
| Address: | 6624 US Hwy 19, New Port Richey, FL, 34652, US |
| Mail Address: | 6624 U.S. HWY 19, NEW PORT RICHEY, FL, 34652, US |
| ZIP code: | 34652 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | FATHER DAVID, LLC, NEW YORK | 4570384 | NEW YORK |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114573748 | 2019-08-09 | 2021-05-06 | 6624 US HIGHWAY 19, NEW PORT RICHEY, FL, 346521739, US | 6624 US HIGHWAY 19, NEW PORT RICHEY, FL, 346521739, US | |||||||||||||||||||||||||
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| Phone | +1 727-807-7050 |
| Fax | 7278076050 |
Authorized person
| Name | DR. SUBA NATHAN |
| Role | PHARMACIST OWNER |
| Phone | 7278077050 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 005454800 |
| State | FL |
| Name | Role |
|---|---|
| FATHER DAVID, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| Nathan Suba | Managing Member | 6624 US Hwy 19, NEW PORT RICHEY, FL, 34652 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-01-23 | 6624 US Hwy 19, New Port Richey, FL 34652 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-02-05 | FATHER DAVID LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-02-05 | 6624 US HIGHWAY 19, NEW PORT RICHEY, FL 34652 | No data |
| CHANGE OF MAILING ADDRESS | 2015-03-19 | 6624 US Hwy 19, New Port Richey, FL 34652 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-21 |
| ANNUAL REPORT | 2024-01-17 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-01-29 |
| ANNUAL REPORT | 2021-02-05 |
| ANNUAL REPORT | 2020-01-16 |
| ANNUAL REPORT | 2019-01-23 |
| ANNUAL REPORT | 2018-01-16 |
| ANNUAL REPORT | 2017-02-14 |
| ANNUAL REPORT | 2016-04-01 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
