| Entity Name: | MY PHARMACY CRYSTAL RIVER, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 27 Apr 2022 (3 years ago) |
| Document Number: | L22000174582 |
| FEI/EIN Number | 88-2600275 |
| Address: | 2710 REW CIRCLE,, SUITE 200,, OCOEE, FL, 34761, US |
| Mail Address: | 2710 REW CIRCLE,, SUITE 200,, OCOEE, FL, 34761, US |
| ZIP code: | 34761 |
| County: | Orange |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1033837307 | 2022-08-22 | 2022-08-22 | 2710 REW CIRCLE SUITE 200, OCOEE, FL, 34761, US | 927 N CITRUS AVE, CRYSTAL RIVER, FL, 34428, US | |||||||||||||||||||
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| Phone | +1 407-654-5414 |
| Fax | 4076549614 |
| Phone | +1 352-565-7342 |
| Fax | 3525655880 |
Authorized person
| Name | BRIAN BRANHAM |
| Role | VP OF FINANCE & SALES |
| Phone | 3212210658 |
Taxonomy
| Taxonomy Code | 207Q00000X - Family Medicine Physician |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| RONALD W. SIKES, ESQUIRE | Agent | 310 SOUTH DILLARD STREET, SUITE 120, WINTER GARDEN, FL, 34787 |
| Name | Role | Address |
|---|---|---|
| BRANHAM BOYD M | Manager | 2710 REW CIRCLE, SUITE 200, OCOEE, FL, 34761 |
| TOMLINSON RAY A | Manager | 2710 REW CIRCLE, SUITE 200, OCOEE, FL, 34761 |
| BRANHAM BRIAN M | Manager | 2710 REW CIRCLE, SUITE 200, OCOEE, FL, 34761 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-03-28 |
| ANNUAL REPORT | 2023-04-05 |
| Florida Limited Liability | 2022-04-27 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
