| Entity Name: | EXCEL PHARMACY PARTNERS LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Company |
| Status: | Active |
| Date Filed: | 17 Oct 2017 (7 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 20 Jun 2019 (6 years ago) |
| Document Number: | M17000008851 |
| FEI/EIN Number | 82-1581323 |
| Address: | 6817 SOUTHPOINT PARKWAY UNIT 2204, JACKSONVILLE, FL 32216 |
| Mail Address: | 3350 Sw 57th Place, Fort Lauderdale, FL 33312 |
| ZIP code: | 32216 |
| County: | Duval |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598474017 | 2022-11-23 | 2022-11-23 | 6817 SOUTHPOINT PKWY STE 2204, JACKSONVILLE, FL, 322168200, US | 6817 SOUTHPOINT PKWY STE 2204, JACKSONVILLE, FL, 322168200, US | |||||||||||||||||||||||||||
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| Phone | +1 904-800-2285 |
| Fax | 9048137905 |
Authorized person
| Name | MARC EISENMANN |
| Role | MANAGER |
| Phone | 2013443691 |
Taxonomy
| Taxonomy Code | 3336S0011X - Specialty Pharmacy |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | STATE LICENSE |
| Number | PH31118 |
| State | FL |
| Issuer | MEDICAID |
| Number | 102482400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| EISENMANN, MARC | Agent | 3350 SW 57TH PLACE, FORT LAUDERDALE, FL 33312 |
| Name | Role | Address |
|---|---|---|
| EISENMANN, MARC | Manager | 3350 SW 57TH PLACE, FORT LAUDERDALE, FL 33312 |
| Name | Role | Address |
|---|---|---|
| PRINCIPE, ROY | MANAGER | 12093 ARIANA ELYSE DR., JACKSONVILLE, FL 32258 |
| LANDSMAN, IRA | MANAGER | 845 JEFFERSON STREET, WOODSMERE, NY 11598 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G17000120685 | STAT PHARMACY | ACTIVE | 2017-11-02 | 2027-12-31 | No data | 6817 SOUTHPOINT PARKWAY, UNIT 2204, JACKSONVILLE, FL, 32216 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| LC AMENDMENT | 2019-06-20 | No data | No data |
| REINSTATEMENT | 2018-11-20 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2018-11-20 | 6817 SOUTHPOINT PARKWAY UNIT 2204, JACKSONVILLE, FL 32216 | No data |
| REGISTERED AGENT NAME CHANGED | 2018-11-20 | EISENMANN, MARC | No data |
| REVOKED FOR ANNUAL REPORT | 2018-09-28 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-05 |
| ANNUAL REPORT | 2023-02-01 |
| ANNUAL REPORT | 2022-01-10 |
| ANNUAL REPORT | 2021-01-10 |
| ANNUAL REPORT | 2020-01-15 |
| LC Amendment | 2019-06-20 |
| ANNUAL REPORT | 2019-02-01 |
| REINSTATEMENT | 2018-11-20 |
| Foreign Limited | 2017-10-17 |
Date of last update: 18 Jan 2025
Sources: Florida Department of State
