| Entity Name: | FILL RX LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 06 Oct 2015 (9 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 14 Nov 2017 (7 years ago) |
| Document Number: | L15000170311 |
| FEI/EIN Number | 81-0753785 |
| Address: | 776 Deltona Blvd, Deltona, FL, 32725, US |
| Mail Address: | 776 Deltona Blvd, Deltona, FL, 32725, US |
| ZIP code: | 32725 |
| County: | Volusia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1578315784 | 2024-04-02 | 2024-10-28 | 776 DELTONA BLVD, DELTONA, FL, 327257107, US | 776 DELTONA BLVD, DELTONA, FL, 327257107, US | |||||||||||||||||||||
|
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| Phone | +1 386-259-4074 |
| Fax | 3862599037 |
Authorized person
| Name | JIGAR PATEL |
| Role | OWNER |
| Phone | 3862594074 |
Taxonomy
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 019544900 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PATEL TULSI K | Agent | 776 Deltona Blvd, Deltona, FL, 32725 |
| Name | Role | Address |
|---|---|---|
| PATEL TULSI K | Manager | 776 Deltona Blvd, Deltona, FL, 32725 |
| PATEL JIGAR | Manager | 776 Deltona Blvd, Deltona, FL, 32725 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000060147 | IPHARMACY | ACTIVE | 2016-06-17 | 2026-12-31 | No data | 776 DELTONA BLVD, DELTONA, FL, 32725 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2020-02-03 | 776 Deltona Blvd, Deltona, FL 32725 | No data |
| CHANGE OF MAILING ADDRESS | 2020-02-03 | 776 Deltona Blvd, Deltona, FL 32725 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-02-03 | 776 Deltona Blvd, Deltona, FL 32725 | No data |
| LC AMENDMENT | 2017-11-14 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-04-12 | PATEL, TULSI K | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-18 |
| ANNUAL REPORT | 2023-02-04 |
| ANNUAL REPORT | 2022-02-01 |
| ANNUAL REPORT | 2021-01-27 |
| ANNUAL REPORT | 2020-02-03 |
| ANNUAL REPORT | 2019-01-14 |
| ANNUAL REPORT | 2018-02-07 |
| LC Amendment | 2017-11-14 |
| ANNUAL REPORT | 2017-04-12 |
| AMENDED ANNUAL REPORT | 2016-12-15 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
