| Entity Name: | ARCHANGEL ONE, LLC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Nov 2013 (11 years ago) |
| Document Number: | L13000164104 |
| FEI/EIN Number | 46-4169695 |
| Address: | 11001 SPRING HILL DRIVE, SPRING HILL, FL, 34608, US |
| Mail Address: | 11001 SPRING HILL DRIVE, SPRING HILL, FL, 34608, US |
| ZIP code: | 34608 |
| County: | Hernando |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1073921128 | 2014-07-31 | 2017-02-14 | 11001 SPRING HILL DR, SPRING HILL, FL, 346085052, US | 11001 SPRING HILL DR, SPRING HILL, FL, 346085052, US | |||||||||||||||||||||||||||||
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| Phone | +1 352-610-4355 |
| Fax | 3526104388 |
Authorized person
| Name | AMIR MESSIHA |
| Role | R.PH. MANAGER/PHARMACY OWNER |
| Phone | 3526104355 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH28365 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2147203 |
| Issuer | MEDICAID |
| Number | 014448200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MESSIHA AMIR A | Agent | 10009 MONTAGUE ST, TAMPA, FL, 33625 |
| Name | Role | Address |
|---|---|---|
| MESSIHA AMIR A | Manager | 11001 SPRING HILL DRIVE, SPRING HILL, FL, 34608 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000073290 | 4 CORNERS PHARMACY | ACTIVE | 2020-06-28 | 2025-12-31 | No data | 11001 SPRING HILL DR, SPRING HILL, FL, 34608 |
| G14000054620 | 4 CORNERS PHARMACY | EXPIRED | 2014-06-06 | 2019-12-31 | No data | 11001 SPRING HILL DR, SPRING HILL, FL, 34608 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2014-06-06 | 11001 SPRING HILL DRIVE, SPRING HILL, FL 34608 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-12 |
| ANNUAL REPORT | 2023-01-27 |
| ANNUAL REPORT | 2022-02-01 |
| ANNUAL REPORT | 2021-01-31 |
| ANNUAL REPORT | 2020-03-18 |
| ANNUAL REPORT | 2019-03-30 |
| ANNUAL REPORT | 2018-02-09 |
| ANNUAL REPORT | 2017-03-17 |
| ANNUAL REPORT | 2016-04-13 |
| ANNUAL REPORT | 2015-03-19 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
