Search icon

MARIETTA PHARMACY LLC - Florida Company Profile

Company Details

Entity Name: MARIETTA PHARMACY LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.

MARIETTA 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.
In Florida, LLCs are governed by Title XXXVI, Chapter 605, Florida Revised Limited Liability Company Act

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: 05 Jun 2012 (13 years ago)
Last Event: LC AMENDMENT
Event Date Filed: 23 Apr 2018 (7 years ago)
Document Number: L12000074847
FEI/EIN Number 45-5456898

Federal Employer Identification (FEI) Number assigned by the IRS.

Address: 8299 W. BEAVER ST, JACKSONVILLE, FL, 32220, US
Mail Address: 8299 W. BEAVER ST, JACKSONVILLE, FL, 32220, US
ZIP code: 32220
County: Duval
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1912253774 2012-07-31 2022-02-24 8299 W BEAVER ST STE 5, JACKSONVILLE, FL, 322202315, US 8299 W BEAVER ST STE 5, JACKSONVILLE, FL, 322202315, US

Contacts

Phone +1 904-999-4884
Fax 9049994883

Authorized person

Name HANESH PATEL
Role RXM
Phone 9049994884

Taxonomy

Taxonomy Code 333600000X - Pharmacy
Is Primary No
Taxonomy Code 3336C0003X - Community/Retail Pharmacy
License Number PH26285
State FL
Is Primary Yes
Taxonomy Code 3336L0003X - Long Term Care Pharmacy
Is Primary No

Other Provider Identifiers

Issuer MEDICAID
Number 007212200
State FL
Issuer NCPDP PROVIDER IDENTIFICATION NUMBER
Number 5711189

Key Officers & Management

Name Role Address
PATEL HANESH Auth 8299 W. BEAVER ST, JACKSONVILLE, FL, 32220
PATEL HANESH Agent 8299 W. BEAVER ST, JACKSONVILLE, FL, 32220

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G12000057979 MARIETTA PHARMACY EXPIRED 2012-06-12 2017-12-31 - 8299 W. BEAVER ST #5, JACKSONVILLE, FL, 32220

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2022-01-25 PATEL, HANESH -
LC AMENDMENT 2018-04-23 - -
CHANGE OF PRINCIPAL ADDRESS 2018-01-16 8299 W. BEAVER ST, SUITE #5, JACKSONVILLE, FL 32220 -
CHANGE OF MAILING ADDRESS 2018-01-16 8299 W. BEAVER ST, SUITE #5, JACKSONVILLE, FL 32220 -
REGISTERED AGENT ADDRESS CHANGED 2018-01-16 8299 W. BEAVER ST, SUITE #5, JACKSONVILLE, FL 32220 -

Documents

Name Date
ANNUAL REPORT 2025-02-21
ANNUAL REPORT 2024-01-29
ANNUAL REPORT 2023-04-19
AMENDED ANNUAL REPORT 2022-09-26
ANNUAL REPORT 2022-01-25
ANNUAL REPORT 2021-01-11
ANNUAL REPORT 2020-02-13
ANNUAL REPORT 2019-04-11
LC Amendment 2018-04-23
ANNUAL REPORT 2018-01-16

Paycheck Protection Program

Loan Number Loan Funded Date SBA Origination Office Code Loan Delivery Method Borrower Street Address
8462117309 2020-05-01 0491 PPP 8299 W BEAVER ST STE 5, JACKSONVILLE, FL, 32220-2315
Loan Status Date 2021-06-17
Loan Status Paid in Full
Loan Maturity in Months 24
SBA Guaranty Percentage 100
Loan Approval Amount (at origination) 32415
Loan Approval Amount (current) 32415
Undisbursed Amount 0
Franchise Name -
Lender Location ID 9551
Servicing Lender Name Bank of America, National Association
Servicing Lender Address 100 N Tryon St, Ste 170, CHARLOTTE, NC, 28202-4024
Rural or Urban Indicator U
Hubzone N
LMI N
Business Age Description Existing or more than 2 years old
Project Address JACKSONVILLE, DUVAL, FL, 32220-2315
Project Congressional District FL-04
Number of Employees 2
NAICS code 446110
Borrower Race Unanswered
Borrower Ethnicity Unknown/NotStated
Business Type Corporation
Originating Lender ID 9551
Originating Lender Name Bank of America, National Association
Originating Lender Address CHARLOTTE, NC
Gender Unanswered
Veteran Unanswered
Forgiveness Amount 22648.94
Forgiveness Paid Date 2021-05-20

Date of last update: 02 Mar 2025

Sources: Florida Department of State