| Entity Name: | SHAFA PHARMACY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 04 Dec 2013 (11 years ago) |
| Document Number: | L13000168023 |
| FEI/EIN Number | 46-4376405 |
| Address: | 6447 LAKE WORTH RD., LAKE WORTH, FL 33414 |
| Mail Address: | 6447 LAKE WORTH RD., LAKE WORTH, FL 33414 |
| ZIP code: | 33414 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1710301502 | 2014-02-13 | 2014-07-21 | 11476 OKEECHOBEE BLVD, ROYAL PALM BEACH, FL, 334118715, US | 11476 ROYAL PALM BEACH BLVD., ROYAL PALM BEACH, FL, 33411, US | |||||||||||||||||||||||
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| Phone | +1 561-360-2530 |
| Fax | 5613602745 |
Authorized person
| Name | MOHSIN KHAN |
| Role | PHARMACY MANAGER |
| Phone | 5616700640 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH27389 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2144243 |
| Name | Role | Address |
|---|---|---|
| MITTENTHAL, JOSHUA M, ESQ. | Agent | 3100 S. FEDERAL HWY., STE. B, DELRAY BEACH, FL 33483 |
| Name | Role | Address |
|---|---|---|
| JAVED, MOHAMMAD T, M.D. | Managing Member | 6447 LAKE WORTH RD., LAKE WORTH, FL 33414 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-19 |
| ANNUAL REPORT | 2023-03-08 |
| ANNUAL REPORT | 2022-03-02 |
| ANNUAL REPORT | 2021-02-25 |
| ANNUAL REPORT | 2020-03-26 |
| ANNUAL REPORT | 2019-03-19 |
| ANNUAL REPORT | 2018-05-01 |
| ANNUAL REPORT | 2017-04-13 |
| ANNUAL REPORT | 2016-04-20 |
| ANNUAL REPORT | 2015-03-19 |
Date of last update: 22 Jan 2025
Sources: Florida Department of State
