| Entity Name: | WEST PALM BEACH PHARMACEUTICALS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 14 Mar 2017 (8 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 07 Jun 2017 (8 years ago) |
| Document Number: | L17000058617 |
| FEI/EIN Number | 821223315 |
| Address: | 2601 SOUTH MILITARY TRAIL, WEST PALM BEACH, FL, 33415, US |
| Mail Address: | 2601 SOUTH MILITARY TRAIL, WEST PALM BEACH, FL, 33415, US |
| ZIP code: | 33415 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1619492691 | 2017-08-10 | 2020-10-15 | 2601 S MILITARY TRL STE 25, WEST PALM BEACH, FL, 334157512, US | 2601 S MILITARY TRL STE 25, WEST PALM BEACH, FL, 334157512, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 561-660-7869 |
| Fax | 5616607879 |
Authorized person
| Name | XIMENA SUSANA PACHECO-VELIZ |
| Role | MANAGER |
| Phone | 5612545461 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
| Taxonomy Code | 332BP3500X - Parenteral & Enteral Nutrition Supplies (DME) |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH30890 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 335E00000X - Prosthetic/Orthotic Supplier |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 022697801 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| PACHECO-VELIZ XIMENA | Agent | 2601 SOUTH MILITARY TRAIL, WEST PALM BEACH, FL, 33415 |
| Name | Role | Address |
|---|---|---|
| PACHECO-VELIZ XIMENA | Manager | 2601 SOUTH MILITARY TRAIL, WEST PALM BEACH, FL, 33415 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000043047 | ACCESS CARE PHARMACY | ACTIVE | 2017-04-20 | 2027-12-31 | No data | 2601 SOUTH MILITARY TRAIL, SUITE # 25, WEST PALM BEACH, FL, 33415 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC STMNT OF RA/RO CHG | 2017-06-07 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-06-07 | PACHECO-VELIZ, XIMENA | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-06-07 | 2601 SOUTH MILITARY TRAIL, SUITE #25, WEST PALM BEACH, FL 33415 | No data |
| LC STMNT OF RA/RO CHG | 2017-04-25 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2017-04-20 | 2601 SOUTH MILITARY TRAIL, SUITE #25, WEST PALM BEACH, FL 33415 | No data |
| CHANGE OF MAILING ADDRESS | 2017-04-20 | 2601 SOUTH MILITARY TRAIL, SUITE #25, WEST PALM BEACH, FL 33415 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-22 |
| ANNUAL REPORT | 2023-04-28 |
| ANNUAL REPORT | 2022-03-30 |
| ANNUAL REPORT | 2021-05-01 |
| ANNUAL REPORT | 2020-05-17 |
| ANNUAL REPORT | 2019-05-01 |
| ANNUAL REPORT | 2018-05-01 |
| CORLCRACHG | 2017-06-07 |
| CORLCRACHG | 2017-04-25 |
| Florida Limited Liability | 2017-03-14 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
