| Entity Name: | BROADWAY DISCOUNT PHARMACY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 12 May 2017 (8 years ago) |
| Document Number: | L17000105566 |
| FEI/EIN Number | 82-1542031 |
| Mail Address: | 4040 SUNSET LAKE DR, LAKELAND, FL 33810 |
| Address: | 1765 NORTH BROADWAY AVE, BARTOW, FL 33830 |
| ZIP code: | 33830 |
| County: | Polk |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1215439609 | 2018-03-01 | 2019-06-25 | 4040 SUNSET LAKE DR, LAKELAND, FL, 338102841, US | 1765 N BROADWAY AVE, BARTOW, FL, 338303104, US | |||||||||||||||||||||
|
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| Phone | +1 201-916-7123 |
| Phone | +1 863-537-7656 |
| Fax | 8635377927 |
Authorized person
| Name | SAMIR DHADUK |
| Role | OWNER |
| Phone | 2019167123 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH31216 |
| State | FL |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| DHADUK, SAMIR R | Agent | 4040 SUNSET LAKE DR, LAKELAND, FL 33810 |
| Name | Role | Address |
|---|---|---|
| DHADUK, SAMIR | MEMBER | 4040 SUNSET LAKE DR, LAKELAND, FL 33810 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2019-12-12 | DHADUK, SAMIR R | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2019-12-12 | 4040 SUNSET LAKE DR, LAKELAND, FL 33810 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-02-11 | 1765 NORTH BROADWAY AVE, BARTOW, FL 33830 | No data |
| CHANGE OF MAILING ADDRESS | 2019-02-11 | 1765 NORTH BROADWAY AVE, BARTOW, FL 33830 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-14 |
| ANNUAL REPORT | 2023-01-18 |
| ANNUAL REPORT | 2022-01-24 |
| ANNUAL REPORT | 2021-01-08 |
| ANNUAL REPORT | 2020-01-03 |
| AMENDED ANNUAL REPORT | 2019-12-12 |
| ANNUAL REPORT | 2019-01-08 |
| ANNUAL REPORT | 2018-02-23 |
| Florida Limited Liability | 2017-05-12 |
Date of last update: 19 Jan 2025
Sources: Florida Department of State
