| Entity Name: | CLINICAL SPECIALTY INFUSIONS OF DALLAS, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Limited Liability Company |
| Status: | Active |
| Date Filed: | 08 Apr 2024 (10 months ago) |
| Document Number: | M24000004488 |
| FEI/EIN Number | 81-1177414 |
| Address: | 459 E. NEW BOSTON ROAD, NASH, TX 75569 |
| Mail Address: | 459 E. NEW BOSTON ROAD, NASH, TX 75569 |
| Place of Formation: | TEXAS |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093547705 | 2024-08-20 | 2024-08-20 | 5340 LEGACY DR STE 115, PLANO, TX, 750243393, US | 5429 E BEAUMONT CENTER BLVD STE 820, TAMPA, FL, 336345248, US | |||||||||||||||||||||||||||||||||
|
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| Phone | +1 833-569-1005 |
Authorized person
| Name | MARITZA MORA |
| Role | DIRECTOR OF LEGAL AND COMPLIANCE |
| Phone | 4302131563 |
Taxonomy
| Taxonomy Code | 251F00000X - Home Infusion Agency |
| Is Primary | No |
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336H0001X - Home Infusion Therapy Pharmacy |
| Is Primary | Yes |
| Taxonomy Code | 3336M0002X - Mail Order Pharmacy |
| Is Primary | No |
| Name | Role |
|---|---|
| URS AGENTS, LLC | Agent |
| Name | Role | Address |
|---|---|---|
| CSI PHARMACY HOLDING COMPANY, LLC | Member | 459 E. NEW BOSTON ROAD, NASH, TX 75569 |
| Name | Role | Address |
|---|---|---|
| SHEETS, JAMES | President | 459 E. NEW BOSTON ROAD, NASH, TX 75569 |
| Name | Role | Address |
|---|---|---|
| WARD, JIM | Vice President | 459 E. NEW BOSTON ROAD, NASH, TX 75569 |
| Name | Role | Address |
|---|---|---|
| BULS, BARRY | Secretary | 459 E. NEW BOSTON ROAD, NASH, TX 75569 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000103625 | CSI PHARMACY | ACTIVE | 2024-08-29 | 2029-12-31 | No data | 5340 LEGACY DR., STE 115, PLANO, TX, 75024 |
| Name | Date |
|---|---|
| Foreign Limited | 2024-04-08 |
Date of last update: 07 Jan 2025
Sources: Florida Department of State
