| Entity Name: | HEALTHPROMOTE PHARMACY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Co. |
| Status: | Active |
| Date Filed: | 09 May 2018 (7 years ago) |
| Last Event: | LC AMENDMENT |
| Event Date Filed: | 13 Nov 2018 (6 years ago) |
| Document Number: | M18000004704 |
| FEI/EIN Number | 36-4806659 |
| Address: | 4268 Cahaba Heights Court, Suite 148, Birmaingham, AL, 35242, US |
| Mail Address: | 4268 Cahaba Heights Court, Suite 148, Birmaingham, AL, 35242, US |
| Place of Formation: | DELAWARE |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1396167623 | 2014-01-06 | 2018-11-30 | 12701 S JOHN YOUNG PKWY STE 120, ORLANDO, FL, 328373422, US | 12701 S JOHN YOUNG PKWY STE 120, ORLANDO, FL, 328373422, US | |||||||||||||||||||||||||||||
|
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| Phone | +1 321-319-1090 |
| Fax | 4076017142 |
Authorized person
| Name | MR. OMAR MEDINA |
| Role | MANAGING MBR/OWNER |
| Phone | 3213191090 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH27352 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 012807900 |
| State | FL |
| Issuer | PK |
| Number | 2143705 |
| Name | Role |
|---|---|
| NRAI SERVICES, INC. | Agent |
| Name | Role |
|---|---|
| OMD, LLC | Member |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2024-04-12 | 4268 Cahaba Heights Court, Suite 148, Birmaingham, AL 35242 | No data |
| CHANGE OF MAILING ADDRESS | 2024-04-12 | 4268 Cahaba Heights Court, Suite 148, Birmaingham, AL 35242 | No data |
| LC AMENDMENT | 2018-11-13 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-12 |
| ANNUAL REPORT | 2023-03-25 |
| ANNUAL REPORT | 2022-03-28 |
| ANNUAL REPORT | 2021-04-19 |
| ANNUAL REPORT | 2020-07-31 |
| ANNUAL REPORT | 2019-02-22 |
| LC Amendment | 2018-11-13 |
| Foreign Limited | 2018-05-09 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
