| Entity Name: | CRESTMARK PHARMACY SERVICES LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 27 Feb 2014 (11 years ago) |
| Document Number: | L14000033777 |
| FEI/EIN Number | 46-4953489 |
| Mail Address: | 421 N MACARTHUR AVE, PANAMA CITY, FL 32401 |
| Address: | 1860 Highland Oaks Blvd, Lutz, FL 33559 |
| ZIP code: | 33559 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598158701 | 2015-03-12 | 2015-03-12 | 1860 HIGHLAND OAKS BLVD, LUTZ, FL, 335597353, US | 1860 HIGHLAND OAKS BLVD, LUTZ, FL, 335597353, US | |||||||||||||||||||||||
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| Phone | +1 813-428-6963 |
| Fax | 8138037503 |
Authorized person
| Name | RANDALL MCELHENEY |
| Role | MANAGER |
| Phone | 8508322773 |
Taxonomy
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| License Number | PH28922 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2150516 |
| Name | Role | Address |
|---|---|---|
| MCELHENEY, RANDALL A | Agent | 421 N MACARTHUR AVE, PANAMA CITY, FL 32401 |
| Name | Role | Address |
|---|---|---|
| MCELHENEY, RANDALL A | Manager | 421 N MACARTHUR AVE, PANAMA CITY, FL 32401 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF MAILING ADDRESS | 2022-04-18 | 1860 Highland Oaks Blvd, Lutz, FL 33559 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-04-18 | 421 N MACARTHUR AVE, PANAMA CITY, FL 32401 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-03-19 | 1860 Highland Oaks Blvd, Lutz, FL 33559 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-01 |
| ANNUAL REPORT | 2023-03-20 |
| AMENDED ANNUAL REPORT | 2022-04-18 |
| ANNUAL REPORT | 2022-04-08 |
| ANNUAL REPORT | 2021-03-16 |
| ANNUAL REPORT | 2020-02-26 |
| ANNUAL REPORT | 2019-03-19 |
| ANNUAL REPORT | 2018-01-18 |
| ANNUAL REPORT | 2017-02-15 |
| ANNUAL REPORT | 2016-02-23 |
Date of last update: 22 Jan 2025
Sources: Florida Department of State
