| Entity Name: | PALM RX PHARMACY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Inactive |
| Date Filed: | 14 Aug 2015 (9 years ago) |
| Date of dissolution: | 19 Aug 2024 (5 months ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 19 Aug 2024 (5 months ago) |
| Document Number: | L15000139501 |
| FEI/EIN Number | 35-2540260 |
| Mail Address: | 5908 Breckenridge Pkwy, TAMPA, FL, 33610, US |
| Address: | 700 1st ST South, SUITE 1, Winter Haven, FL, 33880, US |
| ZIP code: | 33880 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1629413737 | 2013-05-02 | 2020-11-10 | 700 1ST STREET SOUTH, STE 1, WINTER HAVEN, FL, 33880, US | 700 1ST ST S STE 1, WINTER HAVEN, FL, 338803605, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 863-292-6111 |
| Fax | 8632926112 |
Authorized person
| Name | ALPESH PATEL |
| Role | OWNER |
| Phone | 8133042221 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH30172 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2160439 |
| Issuer | MEDICAID |
| Number | 017822200 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PATEL ALPESH | Agent | 5908 BRECKENRIDGE PRKWY, TAMPA, FL, 33610 |
| Name | Role | Address |
|---|---|---|
| PATEL ALPESH | Manager | 5908 BRECKENRIDGE PKWY, TAMPA, FL, 33610 |
| PATEL MANISH | Manager | 5908 BRECKENRIDGE PKWY, TAMPA, FL, 33610 |
| Name | Role |
|---|---|
| BENZER PHARMACY HOLDING LLC | Authorized Member |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000137075 | PALM RX PHARMACY | ACTIVE | 2020-10-22 | 2025-12-31 | No data | 700 1ST STREET SOUTH, STE 1, WINTER HAVEN, FL, 33880 |
| G20000066952 | HAVEN PHARMACY | ACTIVE | 2020-06-15 | 2025-12-31 | No data | 5908 BRECKENRIDGE PARKWAY, TAMPA, FL, 33610 |
| G16000060158 | RELIANCE PHARMACY | EXPIRED | 2016-06-17 | 2021-12-31 | No data | 125 W COUNTRY CLUB DR, TAMPA, FL, 33612 |
| G16000001712 | BENZER PHARMACY 155 | EXPIRED | 2016-01-05 | 2021-12-31 | No data | 125 W. COUNTRY CLUB DR, TAMPA, FL, 33612 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2024-08-19 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2022-09-23 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-10-05 | 5908 BRECKENRIDGE PRKWY, TAMPA, FL 33610 | No data |
| LC STMNT OF RA/RO CHG | 2020-10-05 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2020-10-05 | PATEL, ALPESH | No data |
| LC NAME CHANGE | 2020-08-31 | PALM RX PHARMACY LLC | No data |
| LC NAME CHANGE | 2020-06-15 | HAVEN PHARMACY LLC | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-10-08 | 700 1st ST South, SUITE 1, Winter Haven, FL 33880 | No data |
| LC AMENDMENT | 2018-10-08 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2017-03-21 | 700 1st ST South, SUITE 1, Winter Haven, FL 33880 | No data |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2024-08-19 |
| ANNUAL REPORT | 2021-02-02 |
| CORLCRACHG | 2020-10-05 |
| LC Name Change | 2020-08-31 |
| ANNUAL REPORT | 2020-06-23 |
| LC Name Change | 2020-06-15 |
| ANNUAL REPORT | 2019-02-20 |
| LC Amendment | 2018-10-08 |
| ANNUAL REPORT | 2018-04-14 |
| ANNUAL REPORT | 2017-03-21 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
