| Entity Name: | PRIME CARE PHARMACY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Jan 2021 (4 years ago) |
| Document Number: | L21000044013 |
| FEI/EIN Number | 86-1977450 |
| Address: | 2176 MARINER BLVD, SPRINGHILL, FL, 34609, US |
| Mail Address: | 4 MONET CT, MONMOUTH JUNCTION, NJ, 08852, US |
| ZIP code: | 34609 |
| County: | Hernando |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1457934929 | 2021-05-03 | 2021-05-03 | 2176 MARINER BLVD, SPRING HILL, FL, 346093859, US | 2176 MARINER BLVD, SPRING HILL, FL, 346093859, US | |||||||||||||||||||||||||
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| Phone | +1 352-684-8477 |
| Fax | 3526846877 |
| Phone | +1 352-600-8083 |
| Fax | 3526007033 |
Authorized person
| Name | VENKATESHWARLU THAUDBOINA |
| Role | AGENT |
| Phone | 3526008083 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PHARMACY STATE LICENSE |
| Number | PH33260 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| THAUDBOINA VENKATESHWARLU | Agent | 4404 LIGHTFOOT ST, SPRINGHILL, FL, 34609 |
| Name | Role | Address |
|---|---|---|
| DUA ASHISH | Authorized Member | 4 MONET CT, MONMOUTH JUNCTION, NJ, 08852 |
| Name | Role | Address |
|---|---|---|
| THAUDBOINA VENKATESHWARLU | Authorized Person | 2176 MARINER BLVD, SPRING HILL, FL, 34609 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-12 |
| ANNUAL REPORT | 2023-04-04 |
| ANNUAL REPORT | 2022-03-11 |
| Florida Limited Liability | 2021-01-22 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
