| Entity Name: | MANATEE PHARMACY SERVICES INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 19 Nov 2013 (11 years ago) |
| Last Event: | AMENDMENT |
| Event Date Filed: | 16 Oct 2023 (a year ago) |
| Document Number: | P13000093730 |
| FEI/EIN Number | 46-4131646 |
| Address: | 1802 59TH STREET WEST, BRADENTON, FL, 34209, US |
| Mail Address: | 1802 59TH STREET WEST, BRADENTON, FL, 34209, US |
| ZIP code: | 34209 |
| County: | Manatee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1831515121 | 2014-03-11 | 2023-06-06 | 1802 59TH ST W, BRADENTON, FL, 342094630, US | 1802 59TH ST W, BRADENTON, FL, 342094630, US | |||||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 941-209-1234 |
| Fax | 9412091177 |
Authorized person
| Name | YULIYA KAZLOVA |
| Role | P |
| Phone | 9412091234 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH27278 |
| State | FL |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | PK |
| Number | 2140901 |
| Issuer | MEDICAID |
| Number | 010739800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Walters Nicholas | Agent | 5266 Office Park Blvd. Suite 204, Bradenton, FL, 34203 |
| Name | Role | Address |
|---|---|---|
| KAZLOVA YULIYA | Treasurer | 1802 59TH STREET WEST, BRADENTON, FL, 34209 |
| Name | Role | Address |
|---|---|---|
| KAZLOVA YULIYA | Secretary | 1802 59TH STREET WEST, BRADENTON, FL, 34209 |
| Name | Role | Address |
|---|---|---|
| NAWAZ-CHOWDHRY AQSA | Vice President | 8419 LEGENDS PARKWAY, FORT WAYNE, IN, 46835 |
| Name | Role | Address |
|---|---|---|
| Nawaz Hamad U | President | 5186 78th St Cir E, Bradenton, FL, 34203 |
| NAWAZ HAMAD | President | 1802 59TH STREET WEST, BRADENTON, FL, 34209 |
| Name | Role | Address |
|---|---|---|
| NAWAZ HAMAD | Chairman | 1802 59TH STREET WEST, BRADENTON, FL, 34209 |
| Name | Role | Address |
|---|---|---|
| NAWAZ HAMAD | Director | 1802 59TH STREET WEST, BRADENTON, FL, 34209 |
| Name | Role | Address |
|---|---|---|
| NAWAZ-CHOWDHRY AQSA | Chief Financial Officer | 1802 59TH STREET WEST, BRADENTON, FL, 34209 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G23000009908 | MANATEE DISCOUNT PHARMACY | ACTIVE | 2023-01-21 | 2028-12-31 | No data | 1802 59TH STREET WEST, BRADENTON, FL, 34209 |
| G14000094891 | MANATEE DISCOUNT PHARMACY | EXPIRED | 2014-09-16 | 2019-12-31 | No data | 3549 1ST STR, BRADENTON, FL, 34208 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2023-10-16 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2023-01-23 | Walters, Nicholas | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2020-07-20 | 5266 Office Park Blvd. Suite 204, Bradenton, FL 34203 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2019-08-15 | 1802 59TH STREET WEST, BRADENTON, FL 34209 | No data |
| CHANGE OF MAILING ADDRESS | 2019-08-15 | 1802 59TH STREET WEST, BRADENTON, FL 34209 | No data |
| AMENDMENT | 2017-10-02 | No data | No data |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-19 |
| Amendment | 2023-10-16 |
| ANNUAL REPORT | 2023-01-23 |
| ANNUAL REPORT | 2022-04-05 |
| ANNUAL REPORT | 2021-02-26 |
| ANNUAL REPORT | 2020-07-20 |
| ANNUAL REPORT | 2019-04-02 |
| ANNUAL REPORT | 2018-04-23 |
| AMENDED ANNUAL REPORT | 2017-10-18 |
| Amendment | 2017-10-02 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
