| Entity Name: | PHARMACIST FORMULATIONS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Company |
| Status: | Active |
| Date Filed: | 17 Jan 2024 (a year ago) |
| Document Number: | L24000033942 |
| Address: | 6506 N DAVIS HWY, PENSACOLA, FL 32504 |
| Mail Address: | 9777 PYRAMID CT, STE 230, ENGLEWOOD, CO 80112 |
| ZIP code: | 32504 |
| County: | Escambia |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1104605120 | 2023-09-28 | 2023-09-28 | 6506 N DAVIS HWY, PENSACOLA, FL, 325046957, US | 6506 N DAVIS HWY, PENSACOLA, FL, 325046957, US | |||||||||||||
|
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| Phone | +1 850-473-9190 |
Authorized person
| Name | BRIAN PATRICK HARRISON |
| Role | V.P. OF PHARMACY OPERATIONS |
| Phone | 7042587076 |
Taxonomy
| Taxonomy Code | 171400000X - Health & Wellness Coach |
| Is Primary | Yes |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| REVELATION PHARMACY, LLC | Manager | 9777 PYRAMID CT, STE 230, ENGLEWOOD, CO 80112 |
| Name | Role | Address |
|---|---|---|
| SKINNER, WILLIAM | Chief Financial Officer | 9777 PYRAMID CT, STE 230, ENGLEWOOD, CO 80112 |
| Name | Role | Address |
|---|---|---|
| HODGES, SHAWN | Chief Executive Officer | 9777 PYRAMID CT, STE 230, ENGLEWOOD, CO 80112 |
| Name | Date |
|---|---|
| Florida Limited Liability | 2024-01-17 |
Date of last update: 08 Jan 2025
Sources: Florida Department of State
