| Entity Name: | POLARIS PHARMACY SERVICES OF TAMPA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 26 Aug 2016 (8 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 19 Jun 2017 (8 years ago) |
| Document Number: | L16000160712 |
| FEI/EIN Number | 38-4013748 |
| Address: | 2900 NW 60TH STREET, FORT LAUDERDALE, FL 33309 |
| Mail Address: | 2900 NW 60TH STREET, FORT LAUDERDALE, FL 33309 |
| ZIP code: | 33309 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1154554111 | 2009-08-25 | 2024-01-09 | 2900 NW 60TH STREET, FT. LAUDERDALE, FL, 33309, US | 5908 HAMPTON OAKS PKWY STE N, TAMPA, FL, 336109505, US | |||||||||||||||||||||||||||
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| Phone | +1 954-919-1818 |
| Fax | 9549239261 |
| Phone | +1 877-891-0005 |
| Fax | 8778910006 |
Authorized person
| Name | DAVID ROMBRO |
| Role | CEO |
| Phone | 9549191818 |
Taxonomy
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| License Number | PH30415 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 1048152 |
| Name | Role | Address |
|---|---|---|
| GALBUT, ABRAHAM A | Agent | 4770 BISCAYNE BLVD, SUITE 1400, MIAMI, FL 33137 |
| Name | Role | Address |
|---|---|---|
| ROMBRO, DAVID | Manager | 2900 NW 60TH STREET, FORT LAUDERDALE, FL 33309 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G16000118317 | PRIME PHARMACY EAST | EXPIRED | 2016-11-01 | 2021-12-31 | No data | 2427 PORTER LAKE DRIVE, SUITE 109, SARASOTA, FL, 34240 |
| G16000105014 | PRIME PHARMACY SERVICES | EXPIRED | 2016-09-26 | 2021-12-31 | No data | 2900 NW 60TH ST, FT. LAUDERDALE, FL, 33309 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2017-06-19 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-01-04 |
| ANNUAL REPORT | 2023-02-15 |
| ANNUAL REPORT | 2022-04-15 |
| ANNUAL REPORT | 2021-04-30 |
| ANNUAL REPORT | 2020-06-28 |
| ANNUAL REPORT | 2019-04-25 |
| AMENDED ANNUAL REPORT | 2018-07-10 |
| ANNUAL REPORT | 2018-04-19 |
| LC Amendment | 2017-06-19 |
| ANNUAL REPORT | 2017-04-28 |
Date of last update: 19 Jan 2025
Sources: Florida Department of State
