| Entity Name: | GUARDIAN PHARMACY OF SOUTHWEST FLORIDA, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Company |
| Status: | Active |
| Date Filed: | 17 Nov 2014 (10 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 24 Jan 2018 (7 years ago) |
| Document Number: | M14000008564 |
| FEI/EIN Number | 32-0432429 |
| Mail Address: | 300 Galleria Parkway SE, Suite 800, ATLANTA, GA 30339 |
| Address: | 300 Galleria Parkway SE, Suite 800, Atlanta, GA 30339 |
| Place of Formation: | GEORGIA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1285024125 | 2015-01-30 | 2021-08-27 | PO BOX 11407, DEPT #2464, BIRMINGHAM, AL, 352462464, US | 4873 PLANTATION BLVD., NORTH PORT, FL, 342899503, US | |||||||||||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||||||||||
| Phone | +1 404-554-1647 |
| Fax | 4045541648 |
| Phone | +1 941-255-1987 |
| Fax | 9416295507 |
Authorized person
| Name | MIKE KLEIN |
| Role | PRESIDENT |
| Phone | 9412551987 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| License Number | PH28854 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 014310700 |
| State | FL |
| Issuer | PK |
| Number | 2150227 |
| Name | Role |
|---|---|
| REGISTERED AGENT SOLUTIONS, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| BURKE, FRED P | Manager | 300 Galleria Parkway SE, Suite 800 ATLANTA, GA 30339 |
| MORRIS, DAVID K | Manager | 300 Galleria Parkway SE, Suite 800 ATLANTA, GA 30339 |
| FORBES, G. KENDALL | Manager | 300 Galleria Parkway SE, Suite 800 ATLANTA, GA 30339 |
| Downey, Chad | Manager | 300 Galleria Parkway SE, Suite 800 ATLANTA, GA 30339 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000137919 | GUARDIAN PHARMACY OF NAPLES | ACTIVE | 2024-11-13 | 2029-12-31 | No data | 300 GALLERIA PARKWAY SE STE 800, ATLANTA, GA, 30339 |
| G20000062076 | PATIENT CARE PHARMACY SERVICES | ACTIVE | 2020-06-03 | 2025-12-31 | No data | 171 17TH ST. NW, SUITE 1400, ATLANTA, GA, 30363 |
| G14000124238 | PATIENT CARE PHARMACY SERVICES | EXPIRED | 2014-12-11 | 2019-12-31 | No data | C/O GUARDIAN PHARMACY, LLC, 1776 PEACHTREE RD. NW, SUITE 500 S.TOWER, ATLANTA, GA, 30309 |
| 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 | 2024-04-30 |
| 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: 21 Jan 2025
Sources: Florida Department of State
