| Entity Name: | CCM PHARMACY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 12 Nov 2014 (10 years ago) |
| Last Event: | LC DISSOCIATION MEM |
| Event Date Filed: | 31 Jan 2019 (6 years ago) |
| Document Number: | L14000175729 |
| FEI/EIN Number | 47-2378327 |
| Address: | 6821 W HILLSBOROUGH AVENUE, SUITE 6, TAMPA, FL 33634 |
| Mail Address: | 6821 W HILLSBOROUGH AVENUE, SUITE 6, TAMPA, FL 33634 |
| ZIP code: | 33634 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1417322033 | 2015-12-08 | 2019-02-12 | 6821 W HILLSBOROUGH AVE, SUITE 6, TAMPA, FL, 336345003, US | 6821 W HILLSBOROUGH AVE, SUITE 6, TAMPA, FL, 336345003, US | |||||||||||||||||
|
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| Phone | +1 813-559-1010 |
Authorized person
| Name | KRISTY VELAZQUEZ |
| Role | AMBR |
| Phone | 8135591010 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH29563 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| Velazquez, Kristy | Agent | 6821 W HILLSBOROUGH AVENUE, SUITE 6, TAMPA, FL 33634 |
| Name | Role | Address |
|---|---|---|
| Velazquez, Kristy | Authorized Member | 6821 W HILLSBOROUGH AVENUE, SUITE 6 TAMPA, FL 33634 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC DISSOCIATION MEM | 2019-01-31 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2019-01-25 | Velazquez, Kristy | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-03-27 | 6821 W HILLSBOROUGH AVENUE, SUITE 6, TAMPA, FL 33634 | No data |
| CHANGE OF MAILING ADDRESS | 2015-03-27 | 6821 W HILLSBOROUGH AVENUE, SUITE 6, TAMPA, FL 33634 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2015-03-27 | 6821 W HILLSBOROUGH AVENUE, SUITE 6, TAMPA, FL 33634 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-29 |
| ANNUAL REPORT | 2023-01-29 |
| ANNUAL REPORT | 2022-03-23 |
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-06-01 |
| CORLCDSMEM | 2019-01-31 |
| ANNUAL REPORT | 2019-01-25 |
| ANNUAL REPORT | 2018-04-18 |
| AMENDED ANNUAL REPORT | 2017-12-08 |
| ANNUAL REPORT | 2017-04-25 |
Date of last update: 20 Feb 2025
Sources: Florida Department of State
