| Entity Name: | COUNTRYSIDE PHARMACY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
COUNTRYSIDE PHARMACY LLC is structured as a Limited Liability Company (LLC), a common business structure that offers its members limited liability protection, separating their personal assets from the company's debts and obligations. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 25 Jan 2016 (9 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 25 Jul 2024 (9 months ago) |
| Document Number: | L16000016848 |
| FEI/EIN Number |
81-1281030
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 3058 WENTWORTH WAY, TARPON SPRING, FL, 34688, US |
| Mail Address: | 3058 WENTWORTH WAY, TARPON SPRING, FL, 34688, US |
| ZIP code: | 34688 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336680412 | 2017-03-09 | 2017-03-13 | 2196 MAIN ST STE A, DUNEDIN, FL, 346985650, US | 2196 MAIN ST STE A, DUNEDIN, FL, 346985650, US | |||||||||||||||||||||||||||
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| Phone | +1 727-648-2680 |
| Fax | 7276482695 |
Authorized person
| Name | ADEL YOUSSEF |
| Role | MANAGER |
| Phone | 7276482680 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH30500 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2168277 |
| Name | Role | Address |
|---|---|---|
| Yousef Gena | Manager | 3058 Wentworth Way, Tarpon Springs, FL, 34688 |
| YOUSSEF GENA | Authorized Member | 3058 WENTWORTH WAY, TARPON SPRING, FL, 34688 |
| YOUSSEF GENA | Agent | 3058 WENTWORTH WAY, TARPON SPRING, FL, 34688 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000024181 | SHIELDS PHARMACY | ACTIVE | 2016-03-07 | 2026-12-31 | - | 2196 MAIN STREET, SUITE A, DUNEDIN, FL, 34698 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2024-07-25 | - | - |
| CHANGE OF PRINCIPAL ADDRESS | 2024-07-25 | 3058 WENTWORTH WAY, TARPON SPRING, FL 34688 | - |
| CHANGE OF MAILING ADDRESS | 2024-07-25 | 3058 WENTWORTH WAY, TARPON SPRING, FL 34688 | - |
| REGISTERED AGENT NAME CHANGED | 2024-07-25 | YOUSSEF, GENA | - |
| REGISTERED AGENT ADDRESS CHANGED | 2024-07-25 | 3058 WENTWORTH WAY, TARPON SPRING, FL 34688 | - |
| Name | Date |
|---|---|
| LC Amendment | 2024-07-25 |
| ANNUAL REPORT | 2024-05-01 |
| ANNUAL REPORT | 2023-01-14 |
| ANNUAL REPORT | 2022-01-28 |
| ANNUAL REPORT | 2021-01-23 |
| ANNUAL REPORT | 2020-01-17 |
| ANNUAL REPORT | 2019-04-22 |
| ANNUAL REPORT | 2018-04-02 |
| ANNUAL REPORT | 2017-01-29 |
| Florida Limited Liability | 2016-01-25 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 3222188705 | 2021-03-31 | 0455 | PPS | 2196 Main St Ste A, Dunedin, FL, 34698-5650 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 03 Apr 2025
Sources: Florida Department of State
