| Entity Name: | CREATIVE PHARMACY SOLUTIONS EAST LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 05 Apr 2016 (9 years ago) |
| Last Event: | LC STMNT OF RA/RO CHG |
| Event Date Filed: | 15 Jun 2022 (3 years ago) |
| Document Number: | M16000002813 |
| FEI/EIN Number | 46-5564676 |
| Address: | 7779 Starkey Road, Seminole, FL, 33777, US |
| Mail Address: | 2535 JOHNS PL, JAMESTOWN, NY, 14701, US |
| ZIP code: | 33777 |
| County: | Pinellas |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1972500130 | 2005-07-02 | 2022-07-13 | 2535 JOHNS PL, JAMESTOWN, NY, 147019210, US | 7779 STARKEY RD, SEMINOLE, FL, 337774346, US | |||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 716-720-5121 |
| Fax | 7167086248 |
| Phone | +1 727-381-9799 |
Authorized person
| Name | RICHARD MOON |
| Role | PRESIDENT/OWNER |
| Phone | 7167205121 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | PH30191 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 102422500 |
| State | FL |
| Issuer | PK |
| Number | 2159609 |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY | Agent |
| Name | Role | Address |
|---|---|---|
| MOON RICHARD B | Manager | 2535 JOHNS PL, JAMESTOWN, NY, 14701 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000012693 | PHARMACY INNOVATIONS | ACTIVE | 2021-01-26 | 2026-12-31 | No data | 2535 JOHNS PLACE, JAMESTOWN, NY, 14701 |
| G16000038099 | THE COMPOUNDING SHOP | EXPIRED | 2016-04-14 | 2021-12-31 | No data | 4000 PARK STREET N, ST PETERSBURG, FL, 33709 |
| G16000038103 | TCS LABS | EXPIRED | 2016-04-14 | 2021-12-31 | No data | 4000 PARK STREET N, ST PETERSBURG, FL, 33709 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC STMNT OF RA/RO CHG | 2022-07-15 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2022-07-15 | CORPORATION SERVICE COMPANY | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2022-07-15 | 1201 HAYS STREET, STE #1110, TALLAHASSEE, FL 32301-3056 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2022-03-18 | 7779 Starkey Road, Seminole, FL 33777 | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2025-01-15 |
| ANNUAL REPORT | 2024-02-01 |
| ANNUAL REPORT | 2023-01-30 |
| CORLCRACHG | 2022-06-15 |
| ANNUAL REPORT | 2022-03-18 |
| ANNUAL REPORT | 2021-04-02 |
| ANNUAL REPORT | 2020-02-27 |
| ANNUAL REPORT | 2019-02-22 |
| ANNUAL REPORT | 2018-04-06 |
| ANNUAL REPORT | 2017-03-16 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
