| Entity Name: | VIP PHARMACY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 13 Apr 2015 (10 years ago) |
| Date of dissolution: | 23 Sep 2016 (8 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 23 Sep 2016 (8 years ago) |
| Document Number: | L15000064529 |
| Address: | 2955 SE 3RD COURT, OCALA, FL, 34471 |
| Mail Address: | 2955 SE 3RD COURT, OCALA, FL, 34471 |
| ZIP code: | 34471 |
| County: | Marion |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1376849810 | 2011-02-01 | 2011-02-08 | 5669 NW 195TH DR, MIAMI GARDENS, FL, 330556112, US | 5669 NW 195TH DR, MIAMI GARDENS, FL, 330556112, US | |||||||||||||||||||
|
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| Phone | +1 305-961-1629 |
| Fax | 3056233858 |
Authorized person
| Name | LORIE GRESS |
| Role | OWNER |
| Phone | 3059611629 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 5704057 |
| Name | Role | Address |
|---|---|---|
| KULKARNI RAGHAVENDRA | Agent | 2955 SE 3RD COURT, OCALA, FL, 34471 |
| Name | Role | Address |
|---|---|---|
| DEVAIAH PAGIDIPATI | Manager | 2955 SE 3RD COURT, OCALA, FL, 34471 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2016-09-23 | No data | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2015-04-13 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
