| Entity Name: | EASTPORT PHARMACY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
EASTPORT 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: | 01 Nov 2013 (12 years ago) |
| Document Number: | L13000154268 |
| FEI/EIN Number |
46-4015870
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 8972 S US 1, PORT ST LUCIE, FL, 34952, US |
| Mail Address: | 8972 S US HIGHWAY 1, PORT ST LUCIE, FL, 34952, US |
| ZIP code: | 34952 |
| County: | St. Lucie |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1316346620 | 2014-08-22 | 2015-02-26 | 8972 S US HIGHWAY 1, PORT ST LUCIE, FL, 349523403, US | 8972 S US HIGHWAY 1, PORT ST LUCIE, FL, 349523403, US | |||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 772-800-7267 |
| Fax | 7728007265 |
Authorized person
| Name | HASSAN BAZZI |
| Role | OWNER, MGR, PIC |
| Phone | 7723241512 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH28441 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336S0011X - Specialty Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | PK |
| Number | 2146100 |
| Issuer | MEDICAID |
| Number | 013952500 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EASTPORT PHARMACY LLC | 2023 | 464015870 | 2025-02-03 | EASTPORT PHARMACY LLC | 6 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2025-02-03 |
| Name of individual signing | HASSAN BAZZI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 446110 |
| Sponsor’s telephone number | 3134676322 |
| Plan sponsor’s address | 8974 S US HIGHWAY 1, PORT SAINT LUCIE, FL, 34952 |
Signature of
| Role | Plan administrator |
| Date | 2024-11-29 |
| Name of individual signing | HASSAN BAZZI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 446110 |
| Sponsor’s telephone number | 3134676322 |
| Plan sponsor’s address | 8974 S US HIGHWAY 1, PORT SAINT LUCIE, FL, 34952 |
Signature of
| Role | Plan administrator |
| Date | 2023-12-01 |
| Name of individual signing | HASSAN BAZZI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 446110 |
| Sponsor’s telephone number | 3134676322 |
| Plan sponsor’s address | 8974 S US HIGHWAY 1, PORT SAINT LUCIE, FL, 34952 |
Signature of
| Role | Plan administrator |
| Date | 2022-10-14 |
| Name of individual signing | HASSAN BAZZI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2019-01-01 |
| Business code | 446110 |
| Sponsor’s telephone number | 3134676322 |
| Plan sponsor’s address | 8974 S US HIGHWAY 1, PORT SAINT LUCIE, FL, 34952 |
Signature of
| Role | Plan administrator |
| Date | 2023-12-01 |
| Name of individual signing | HASSAN BAZZI |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| BAZZI HASSAN HPHARM.D | Managing Member | 8974 S US 1, PORT ST LUCIE, FL, 34952 |
| BAZZI HASSAN HPHARM.D | Agent | 8974 S US 1, PORT ST LUCIE, FL, 34952 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2021-01-17 | 8972 S US 1, PORT ST LUCIE, FL 34952 | - |
| CHANGE OF MAILING ADDRESS | 2021-01-17 | 8972 S US 1, PORT ST LUCIE, FL 34952 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2015-02-05 | 8974 S US 1, PORT ST LUCIE, FL 34952 | - |
| REGISTERED AGENT NAME CHANGED | 2014-02-10 | BAZZI, HASSAN H, PHARM.D | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-21 |
| ANNUAL REPORT | 2023-03-08 |
| ANNUAL REPORT | 2022-03-02 |
| ANNUAL REPORT | 2021-01-17 |
| ANNUAL REPORT | 2020-06-11 |
| ANNUAL REPORT | 2019-02-13 |
| ANNUAL REPORT | 2018-02-09 |
| ANNUAL REPORT | 2017-04-27 |
| ANNUAL REPORT | 2016-03-28 |
| ANNUAL REPORT | 2015-02-05 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1864087401 | 2020-05-05 | 0455 | PPP | 8972 S US HIGHWAY 1, PORT ST LUCIE, FL, 34952 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 03 May 2025
Sources: Florida Department of State
