| Entity Name: | PALMYRA PHARMACY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Florida Limited Liability Co.
PALMYRA 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: | 05 Jul 2016 (9 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 29 Sep 2021 (3 years ago) |
| Document Number: | L16000127539 |
| FEI/EIN Number |
81-3134546
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 13060 CORTEZ BLVD, BROOKSVILLE, FL, 34613, US |
| Mail Address: | 13060 CORTEZ BLVD, BROOKSVILLE, FL, 34613, US |
| ZIP code: | 34613 |
| County: | Hernando |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1497209159 | 2016-08-11 | 2021-12-20 | 13060 CORTEZ BLVD, BROOKSVILLE, FL, 346134854, US | 13080 CORTEZ BLVD, BROOKSVILLE, FL, 346134854, US | |||||||||||||||||||||||||
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| Phone | +1 352-600-7572 |
| Fax | 3526007675 |
Authorized person
| Name | MOHAB HARAKA |
| Role | MANAGER |
| Phone | 3522133815 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 30300 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 019942700 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Haraka Mohab | Authorized Member | 9307 MERLOT CIRCLE, Seffner, FL, 33584 |
| HARAKA MOHAB | Agent | 9307 MERLOT CIRCLE, SEFFNER, FL, 33584 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-05-12 | 13060 CORTEZ BLVD, BROOKSVILLE, FL 34613 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2023-05-12 | 9307 MERLOT CIRCLE, SEFFNER, FL 33584 | - |
| CHANGE OF MAILING ADDRESS | 2023-05-12 | 13060 CORTEZ BLVD, BROOKSVILLE, FL 34613 | - |
| REINSTATEMENT | 2021-09-29 | - | - |
| REGISTERED AGENT NAME CHANGED | 2021-09-29 | HARAKA, MOHAB | - |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | - | - |
| LC STMNT OF RA/RO CHG | 2018-05-10 | - | - |
| LC DISSOCIATION MEM | 2018-05-10 | - | - |
| LC AMENDMENT | 2017-06-05 | - | - |
| LC AMENDMENT | 2016-11-28 | - | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-08 |
| AMENDED ANNUAL REPORT | 2023-05-12 |
| ANNUAL REPORT | 2023-03-03 |
| ANNUAL REPORT | 2022-03-22 |
| REINSTATEMENT | 2021-09-29 |
| ANNUAL REPORT | 2020-05-26 |
| ANNUAL REPORT | 2019-04-30 |
| CORLCDSMEM | 2018-05-10 |
| CORLCRACHG | 2018-05-10 |
| ANNUAL REPORT | 2018-04-30 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 1577147305 | 2020-04-28 | 0491 | PPP | 13080 cortez blvd, brooksville, FL, 34613 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 8117998408 | 2021-02-12 | 0491 | PPS | 13080 Cortez Blvd, Brooksville, FL, 34613-4854 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 03 Mar 2025
Sources: Florida Department of State
