| Entity Name: | EMERALD COMPOUNDING PHARMACY LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 16 Jan 2024 (a year ago) |
| Document Number: | L24000031566 |
| FEI/EIN Number | 99-0705099 |
| Address: | 5325 Primrose Lake Cir, Suite A, TAMPA, FL 33647 |
| Mail Address: | 5325 Primrose Lake Cir, Suite A, TAMPA, FL 33647 |
| ZIP code: | 33647 |
| County: | Hillsborough |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1508619966 | 2024-04-08 | 2024-04-12 | 5325 PRIMROSE LAKE CIR STE A, TAMPA, FL, 336473540, US | 5325 PRIMROSE LAKE CIR STE A, TAMPA, FL, 336473540, US | |||||||||||||
|
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| Phone | +1 347-861-5152 |
Authorized person
| Name | DR. AHMAD GHROUF |
| Role | DIRECTOR |
| Phone | 3478615152 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| GHROUF, AHMAD | Agent | 5004 E FOWLER AVE, C153, TAMPA, FL 33617 |
| Name | Role | Address |
|---|---|---|
| GHROUF, AHMAD | Manager | 5004 E FOWLER AVE, TAMPA, FL 33617 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-25 | 5325 Primrose Lake Cir, Suite A, TAMPA, FL 33647 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-25 | 5325 Primrose Lake Cir, Suite A, TAMPA, FL 33647 | No data |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-01-16 |
Date of last update: 09 Feb 2025
Sources: Florida Department of State
