| Entity Name: | GUARDIAN PHARMACY OF NW FLORIDA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 14 Jan 2011 (14 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 24 Jan 2018 (7 years ago) |
| Document Number: | M11000000184 |
| FEI/EIN Number | 273638347 |
| Address: | 300 Galleria Parkway SE, Atlanta, GA, 30339, US |
| Mail Address: | 300 Galleria Parkway SE, ATLANTA, GA, 30339, US |
| Place of Formation: | GEORGIA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1861798613 | 2011-01-26 | 2022-07-21 | GUARDIAN PHARMACY OF NW FLORIDA DEPT 2401, P.O. BOX 11407, BIRMINGHAM, AL, 352460001, US | 212 N WILSON ST, CRESTVIEW, FL, 325363438, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 404-389-1316 |
| Phone | +1 850-306-3003 |
| Fax | 8503063004 |
Authorized person
| Name | ROBERT DUNN |
| Role | PRESIDENT |
| Phone | 8503063003 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| License Number | PH25396 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2129820 |
| Issuer | MEDICAID |
| Number | 003506200 |
| State | FL |
| Name | Role |
|---|---|
| REGISTERED AGENT SOLUTIONS, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| MORRIS DAVID K | Manager | 300 Galleria Parkway SE, ATLANTA, GA, 30339 |
| FORBES G. KENDALL | Manager | 300 Galleria Parkway SE, ATLANTA, GA, 30339 |
| MITCHELL JOSEPH | Manager | 2851 REMINGTON GREEN CIRCLE, TALLAHASSEE, FL, 32308 |
| DUNN ROBERT E | Manager | 3549 BROOKWOOD ROAD, BIRMINGHAM, AL, 35223 |
| DOWNEY CHAD | Manager | 300 Galleria Parkway SE, ATLANTA, GA, 30339 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000035202 | GUARDIAN PHARMACY GULF COAST | ACTIVE | 2023-03-16 | 2028-12-31 | No data | 300 GALLERIA PARKWAY SE, SUITE 800, ATLANTA, GA, 30339 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2023-05-01 | 300 Galleria Parkway SE, Suite 800, Atlanta, GA 30339 | No data |
| CHANGE OF MAILING ADDRESS | 2023-05-01 | 300 Galleria Parkway SE, Suite 800, Atlanta, GA 30339 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2023-04-27 | 2894 REMINGTON GREEN LANE, SUITE A, TALLAHASSEE, FL 32308 | No data |
| LC STMNT OF RA/RO CHG | 2018-01-24 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2018-01-24 | REGISTERED AGENT SOLUTIONS, INC. | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-27 |
| ANNUAL REPORT | 2023-05-01 |
| ANNUAL REPORT | 2022-04-29 |
| ANNUAL REPORT | 2021-04-26 |
| ANNUAL REPORT | 2020-05-01 |
| ANNUAL REPORT | 2019-04-23 |
| ANNUAL REPORT | 2018-04-30 |
| CORLCRACHG | 2018-01-24 |
| ANNUAL REPORT | 2017-04-10 |
| ANNUAL REPORT | 2016-04-15 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
