| Entity Name: | PILL BOX PINES WEST, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Oct 2012 (12 years ago) |
| Document Number: | L12000125120 |
| FEI/EIN Number | 46-1194940 |
| Address: | 17503 PINES BLVD., PEMBROKE PINES, FL, 33029, US |
| Mail Address: | 17503 PINES BLVD., PEMBROKE PINES, FL, 33029, US |
| ZIP code: | 33029 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831538636 | 2013-06-14 | 2018-07-19 | 17503 PINES BLVD, PEMBROKE PINES, FL, 330291519, US | 17503 PINES BLVD, PEMBROKE PINES, FL, 330291519, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 954-443-7455 |
| Fax | 9543746263 |
Authorized person
| Name | BARBARA SAMMARCO |
| Role | PHARMACY MANAGER/MEMBER |
| Phone | 9544437455 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH26925 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 009056700 |
| State | FL |
| Issuer | PK |
| Number | 2140924 |
| Name | Role | Address |
|---|---|---|
| PRESSMAN STEVEN | Agent | 1700 N.W. 122ND TERR,, PEMBROKE PINES, FL, 33026 |
| Name | Role | Address |
|---|---|---|
| PRESSMAN STEVEN | Managing Member | 1700 N.W. 122ND TERR., PEMBROKE PINES, FL, 33026 |
| Name | Role | Address |
|---|---|---|
| Sammarco Barbara | Auth | 17503 PINES BLVD., PEMBROKE PINES, FL, 33029 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2019-04-02 | 17503 PINES BLVD., PEMBROKE PINES, FL 33029 | No data |
| CHANGE OF MAILING ADDRESS | 2019-04-02 | 17503 PINES BLVD., PEMBROKE PINES, FL 33029 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-01-26 |
| ANNUAL REPORT | 2021-01-29 |
| ANNUAL REPORT | 2020-01-15 |
| ANNUAL REPORT | 2019-04-02 |
| ANNUAL REPORT | 2018-01-19 |
| ANNUAL REPORT | 2017-03-29 |
| ANNUAL REPORT | 2016-02-03 |
| ANNUAL REPORT | 2015-01-12 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
