| Entity Name: | KING PHARMACY & COMPOUNDING LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 Aug 2013 (11 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 27 Dec 2017 (7 years ago) |
| Document Number: | L13000123449 |
| FEI/EIN Number | 46-3549585 |
| Address: | 31201 US HIGHWAY 19 N SUITE 1, PALM HARBOR, FL, 34684, US |
| Mail Address: | 31201 US HIGHWAY 19 N SUITE 1, PALM HARBOR, FL, 34684, US |
| ZIP code: | 34684 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1851728703 | 2013-10-08 | 2016-07-12 | 31201 US HIGHWAY 19 N, SUITE 1, PALM HARBOR, FL, 346844422, US | 31201 US HIGHWAY 19 N, PALM HARBOR, FL, 346844422, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 727-772-6868 |
| Fax | 7277726969 |
Authorized person
| Name | SHADY ABDELMASIH |
| Role | RPH MANAGER |
| Phone | 7277726868 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH28918 |
| 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 | PK |
| Number | 2150420 |
| Issuer | MEDICAID |
| Number | 014421300 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MESSIAH SHADY S | Agent | 31201 US HIGHWAY 19 N SUITE 1, PALM HARBOR, FL, 34684 |
| Name | Role | Address |
|---|---|---|
| MESSIAH SHADY S | Manager | 31201 US HIGHWAY 19 N SUITE 1, PALM HARBOR, FL, 34684 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2018-01-16 | MESSIAH, SHADY S | No data |
| LC AMENDMENT | 2017-12-27 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-08 |
| ANNUAL REPORT | 2023-01-31 |
| ANNUAL REPORT | 2022-02-03 |
| ANNUAL REPORT | 2021-02-02 |
| ANNUAL REPORT | 2020-01-20 |
| ANNUAL REPORT | 2019-01-10 |
| ANNUAL REPORT | 2018-01-16 |
| LC Amendment | 2017-12-27 |
| ANNUAL REPORT | 2017-02-09 |
| ANNUAL REPORT | 2016-01-25 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
