| Entity Name: | FLEMING ISLAND PHARMACY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 01 Oct 2013 (11 years ago) |
| Document Number: | L13000138054 |
| FEI/EIN Number | 46-3771779 |
| Address: | 2349 VILLAGE SQUARE PARKWAY, FLEMING ISLAND, FL, 32003, US |
| Mail Address: | 2349 VILLAGE SQUARE PARKWAY, FLEMING ISLAND, FL, 32003, US |
| ZIP code: | 32003 |
| County: | Clay |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1760882245 | 2014-09-03 | 2017-02-20 | 2349 VILLAGE SQUARE PKWY STE 106, SUITE# 106, FLEMING ISLAND, FL, 320034319, US | 2349 VILLAGE SQUARE PKWY STE 106, FLEMING ISLAND, FL, 320034319, US | |||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 904-644-8233 |
| Fax | 9044584444 |
Authorized person
| Name | MIKHIL JOSEPH |
| Role | PHARMACIST/OWNER |
| Phone | 9047187352 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH27325 |
| 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 | MEDICAID |
| Number | 013196400 |
| State | FL |
| Issuer | PK |
| Number | 2147634 |
| Name | Role | Address |
|---|---|---|
| JOSEPH MIKHIL | Agent | 2349 VILLAGE SQUARE PARKWAY, FLEMING ISLAND, FL, 32003 |
| Name | Role | Address |
|---|---|---|
| JOSEPH MIKHIL | Managing Member | 2349 VILLAGE SQUARE PARKWAY, FLEMING ISLAND, FL, 32003 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2015-02-01 | 2349 VILLAGE SQUARE PARKWAY, SUITE # 106, FLEMING ISLAND, FL 32003 | No data |
| CHANGE OF MAILING ADDRESS | 2015-02-01 | 2349 VILLAGE SQUARE PARKWAY, SUITE # 106, FLEMING ISLAND, FL 32003 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-02-01 | 2349 VILLAGE SQUARE PARKWAY, SUITE # 106, FLEMING ISLAND, FL 32003 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-29 |
| ANNUAL REPORT | 2023-04-20 |
| ANNUAL REPORT | 2022-04-20 |
| ANNUAL REPORT | 2021-02-09 |
| ANNUAL REPORT | 2020-07-29 |
| ANNUAL REPORT | 2019-04-15 |
| ANNUAL REPORT | 2018-03-26 |
| ANNUAL REPORT | 2017-04-24 |
| ANNUAL REPORT | 2016-04-26 |
| ANNUAL REPORT | 2015-02-01 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
