| Entity Name: | MEDCITY PHARMACY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
MEDCITY 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. |
| 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: | 10 Jan 2013 (12 years ago) |
| Document Number: | L13000005239 |
| FEI/EIN Number |
46-1762660
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 463688 SR 200,, SUITE #6, YULEE, FL, 32097, US |
| Mail Address: | 463688 SR 200,, SUITE #6, YULEE, FL, 32097, US |
| ZIP code: | 32097 |
| County: | Nassau |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1992047260 | 2013-03-25 | 2013-03-25 | 11988 MARLDON LN, JACKSONVILLE, FL, 322589459, US | 463688 SR 200, SUITE #6, YULEE, FL, 32097, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 904-252-1568 |
| Phone | +1 904-432-3810 |
| Fax | 9044323811 |
Authorized person
| Name | SUMANTH EDARA |
| Role | CO-OWNER |
| Phone | 9042521568 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH26731 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 5713816 |
| Name | Role | Address |
|---|---|---|
| EDARA NAGARAJA RAJES | Managing Member | 169 AMALURRA TRL, SAINT JOHNS, FL, 32259 |
| EDARA SUMANTH | Managing Member | 169 AMALURRA TRL, SAINT JOHNS, FL, 32259 |
| EDARA SUMANTH K | Agent | 463688 SR 200,, YULEE, FL, 32097 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2016-03-10 | EDARA, SUMANTH KUMAR | - |
| REGISTERED AGENT ADDRESS CHANGED | 2016-03-10 | 463688 SR 200,, SUITE #6, YULEE, FL 32097 | - |
| CHANGE OF PRINCIPAL ADDRESS | 2013-08-20 | 463688 SR 200,, SUITE #6, YULEE, FL 32097 | - |
| CHANGE OF MAILING ADDRESS | 2013-08-20 | 463688 SR 200,, SUITE #6, YULEE, FL 32097 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-05-10 |
| ANNUAL REPORT | 2023-04-13 |
| ANNUAL REPORT | 2022-04-27 |
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-05-01 |
| ANNUAL REPORT | 2019-04-18 |
| ANNUAL REPORT | 2018-01-25 |
| ANNUAL REPORT | 2017-01-05 |
| ANNUAL REPORT | 2016-03-10 |
| ANNUAL REPORT | 2015-02-26 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5192447701 | 2020-05-01 | 0491 | PPP | 463688 STATE ROAD 200 STE 6, YULEE, FL, 32097-0304 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 03 Apr 2025
Sources: Florida Department of State
