| Entity Name: | PINE ISLAND DRUGS, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Active |
| Date Filed: | 12 Sep 1995 (29 years ago) |
| Document Number: | P95000070325 |
| FEI/EIN Number | 65-0614881 |
| Address: | 8844 B STATE ROAD 84, FORT LAUDERDALE, FL 33324 |
| Mail Address: | 8844 B STATE ROAD 84, FORT LAUDERDALE, FL 33324 |
| ZIP code: | 33324 |
| County: | Broward |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1316098395 | 2007-01-16 | 2024-10-15 | 8844 W STATE ROAD 84, UNIT B, DAVIE, FL, 33324, US | 8844 W STATE ROAD 84, UNIT B, DAVIE, FL, 333244455, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 954-424-3784 |
| Fax | 9544243412 |
Authorized person
| Name | SITORA KOVAZODA |
| Role | PRESIDENT |
| Phone | 9544243784 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH13774 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | PK |
| Number | 2009615 |
| Issuer | MEDICAID |
| Number | 103446400 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| Kovazoda, Sitora | Agent | 8844 B STATE RD 84, FORT LAUDERDALE, FL 33324 |
| Name | Role | Address |
|---|---|---|
| Kovazoda, Sitora | President | 8844 B STATE ROAD 84, FORT LAUDERDALE, FL 33324 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000096530 | NEIGHBORHOOD DRUGS OF DAVIE | ACTIVE | 2024-08-14 | 2029-12-31 | No data | 8844 W. STATE ROAD84,UNIT B, DAVIE, FL, 33324 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-07-09 | Kovazoda, Sitora | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-02-16 | 8844 B STATE ROAD 84, FORT LAUDERDALE, FL 33324 | No data |
| CHANGE OF MAILING ADDRESS | 2011-02-16 | 8844 B STATE ROAD 84, FORT LAUDERDALE, FL 33324 | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2011-02-16 | 8844 B STATE RD 84, FORT LAUDERDALE, FL 33324 | No data |
| Name | Date |
|---|---|
| AMENDED ANNUAL REPORT | 2024-07-09 |
| ANNUAL REPORT | 2024-02-12 |
| ANNUAL REPORT | 2023-01-06 |
| ANNUAL REPORT | 2022-03-05 |
| ANNUAL REPORT | 2021-03-21 |
| ANNUAL REPORT | 2020-02-02 |
| ANNUAL REPORT | 2019-02-10 |
| ANNUAL REPORT | 2018-01-12 |
| ANNUAL REPORT | 2017-01-18 |
| ANNUAL REPORT | 2016-03-07 |
| Loan Number | Loan Funded Date | SBA Origination Office Code | Loan Delivery Method | Borrower Street Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 5902158100 | 2020-07-20 | 0455 | PPP | 8844 W State Road 84, Davie, FL, 33324 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Date of last update: 02 Feb 2025
Sources: Florida Department of State
