| Entity Name: | DIRECT PHARMACY SERVICES, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 06 Jan 2014 (11 years ago) |
| Date of dissolution: | 23 Aug 2019 (5 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 23 Aug 2019 (5 years ago) |
| Document Number: | L14000002260 |
| FEI/EIN Number | 46-4455829 |
| Address: | 1230 N OCEAN BLVD., GULF STREAM, FL, 33483, US |
| Mail Address: | 1230 N OCEAN BLVD., GULF STREAM, FL, 33483, US |
| ZIP code: | 33483 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1144231788 | 2006-08-10 | 2015-04-22 | 9332 ANNAPOLIS RD, STE 211, LANHAM, MD, 207063113, US | 6635 W COMMERCIAL BLVD, SUITE 116, TAMARAC, FL, 333192100, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| Phone | +1 301-918-1711 |
| Fax | 3019181717 |
| Phone | +1 954-720-0222 |
| Fax | 9547200336 |
Authorized person
| Name | CHIULING WANG |
| Role | VP OF VENDOR RELATIONS |
| Phone | 3019181714 |
Taxonomy
| Taxonomy Code | 183500000X - Pharmacist |
| State | MD |
| Is Primary | No |
| Taxonomy Code | 1835G0303X - Geriatric Pharmacist |
| State | MD |
| Is Primary | No |
| Taxonomy Code | 1835N0905X - Nuclear Pharmacist |
| State | MD |
| Is Primary | No |
| Taxonomy Code | 1835N1003X - Nutrition Support Pharmacist |
| State | MD |
| Is Primary | No |
| Taxonomy Code | 1835P0018X - Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| State | MD |
| Is Primary | No |
| Taxonomy Code | 1835P1200X - Pharmacotherapy Pharmacist |
| State | MD |
| Is Primary | No |
| Taxonomy Code | 1835P1300X - Psychiatric Pharmacist |
| State | MD |
| Is Primary | No |
| Taxonomy Code | 1835X0200X - Oncology Pharmacist |
| State | MD |
| Is Primary | No |
| Taxonomy Code | 333600000X - Pharmacy |
| State | MD |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH22076 |
| 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 | 3336M0002X - Mail Order Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336S0011X - Specialty Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | P008009737 |
| State | MI |
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 1019909 |
| Issuer | MEDICAID |
| Number | 014010400 |
| State | MD |
| Name | Role | Address |
|---|---|---|
| STAPLETON JACK L | Agent | 1230 N OCEAN BLVD., GULF STREAM, FL, 33483 |
| Name | Role | Address |
|---|---|---|
| STAPLETON JACK L | Manager | 1230 N OCEAN BLVD., GULF STREAM, FL, 33483 |
| Name | Role | Address |
|---|---|---|
| STAPETON JACK L | Authorized Member | 1230 N OCEAN BLVD., GULF STREAM, FL, 33483 |
| STAPLETON VICTORIA V | Authorized Member | 1230 N OCEAN BLVD., GULF STREAM, FL, 33483 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2019-08-23 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-05-23 | 1230 N OCEAN BLVD., GULF STREAM, FL 33483 | No data |
| CHANGE OF MAILING ADDRESS | 2019-05-23 | 1230 N OCEAN BLVD., GULF STREAM, FL 33483 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-05-23 | 1230 N OCEAN BLVD., GULF STREAM, FL 33483 | No data |
| LC AMENDMENT | 2014-07-17 | No data | No data |
| LC AMENDMENT | 2014-07-08 | No data | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2019-08-23 |
| ANNUAL REPORT | 2019-05-23 |
| ANNUAL REPORT | 2018-04-30 |
| ANNUAL REPORT | 2017-04-30 |
| ANNUAL REPORT | 2016-05-01 |
| ANNUAL REPORT | 2015-04-29 |
| LC Amendment | 2014-07-17 |
| LC Amendment | 2014-07-08 |
| Florida Limited Liability | 2014-01-06 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
