| Entity Name: | GANESHKRUPA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 10 Aug 2016 (8 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 05 Oct 2020 (4 years ago) |
| Document Number: | L16000149956 |
| FEI/EIN Number | 81-3600878 |
| Address: | 502 Sunport Ln, Suite 550, Orlando, FL, 32809, US |
| Mail Address: | 15461 SW 12th Street, Suite 108, Sunrise, FL, 33326, US |
| ZIP code: | 32809 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1639669989 | 2018-05-12 | 2022-07-28 | 2 BERGEN TPKE, RIDGEFIELD PARK, NJ, 076602390, US | 502 SUNPORT LN STE 550, ORLANDO, FL, 328098125, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 908-241-6337 |
| Fax | 9086344038 |
| Phone | +1 813-548-2493 |
| Fax | 8132788025 |
Authorized person
| Name | JOEL ZUPNICK |
| Role | VICE PRESIDENT |
| Phone | 9082416337 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH31399 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 101668600 |
| State | FL |
| Name | Role |
|---|---|
| SPECIALTY RX HOLDINGS TAMPA, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| Schwartz Eliezer | Auth | 15461 SW 12th Street, Sunrise, FL, 33326 |
| SPECIALTY RX HOLDINGS TAMPA, LLC | Auth | No data |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000022753 | SPECIALTY RX FLW | ACTIVE | 2021-02-16 | 2026-12-31 | No data | 15461 SW 12TH STREET, SUITE 108, SUNRISE, FL, 33326 |
| G20000067100 | FISHHAWK PHARMACY | ACTIVE | 2020-06-15 | 2025-12-31 | No data | 5908 BRECKENRIDGE PARKWAY, TAMPA, FL, 33610 |
| G18000132119 | BENZER PHARMACY | EXPIRED | 2018-12-14 | 2023-12-31 | No data | 6902 SILVER SAGE CIR, TAMPA, FL, 33634 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-04-20 | 502 Sunport Ln, Suite 550, Orlando, FL 32809 | No data |
| CHANGE OF MAILING ADDRESS | 2021-02-16 | 502 Sunport Ln, Suite 550, Orlando, FL 32809 | No data |
| REGISTERED AGENT NAME CHANGED | 2021-02-16 | Specialty RX Holdings Tampa, LLC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2021-02-16 | 15461 SW 12th Street, Suite 108, Sunrise, FL 33326 | No data |
| LC AMENDMENT | 2020-10-05 | No data | No data |
| LC AMENDMENT | 2019-07-11 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J21000094619 | TERMINATED | 1000000878071 | HILLSBOROU | 2021-02-23 | 2031-03-03 | $ 605.44 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, TAMPA SERVICE CENTER, 5483 W WATERS AVE STE 1210, TAMPA FL336341236 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-09 |
| ANNUAL REPORT | 2023-04-20 |
| ANNUAL REPORT | 2022-03-03 |
| ANNUAL REPORT | 2021-02-16 |
| LC Amendment | 2020-10-05 |
| ANNUAL REPORT | 2020-03-03 |
| LC Amendment | 2019-07-11 |
| ANNUAL REPORT | 2019-03-18 |
| ANNUAL REPORT | 2018-03-20 |
| ANNUAL REPORT | 2017-02-09 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
