| Entity Name: | RICHEY MEDICAL PHARMACY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 30 Oct 2019 (5 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 30 Sep 2021 (3 years ago) |
| Document Number: | L19000270119 |
| FEI/EIN Number | 843665836 |
| Address: | 5346 GRAND BOULEVARD, NEW PORT RICHEY, FL, 34652, US |
| Mail Address: | 4939 FLORAMAR TER, # 207, NEW PORT RICHEY, FL, 34652, US |
| ZIP code: | 34652 |
| County: | Pasco |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1245877406 | 2019-12-06 | 2020-08-21 | 4939 FLORAMAR TER APT 207, NEW PORT RICHEY, FL, 346523303, US | 5346 GRAND BLVD, NEW PORT RICHEY, FL, 346524012, US | |||||||||||||||||||||||||||||||
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| Phone | +1 813-431-1718 |
| Phone | +1 727-807-5344 |
| Fax | 7278076320 |
Authorized person
| Name | SANDRA MARCOS |
| Role | OWNER/ PHARMACIST IN CHARGE |
| Phone | 8134311718 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | Yes |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 105880500 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MARCOS SANDRA | Agent | 4939 FLORAMAR TER, NEW PORT RICHEY, FL, 34652 |
| Name | Role | Address |
|---|---|---|
| MARCOS SANDRA | Manager | 4939 FLORAMAR TER # 207, NEW PORT RICHEY, FL, 34652 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REINSTATEMENT | 2021-09-30 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2021-09-30 | MARCOS, SANDRA | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2021-09-24 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-30 |
| ANNUAL REPORT | 2023-04-27 |
| ANNUAL REPORT | 2022-04-28 |
| REINSTATEMENT | 2021-09-30 |
| Florida Limited Liability | 2019-10-30 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
