THE CUSTOM PRESCRIPTION SHOPPE, LLC

Headquarter

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Company Details

Legal Name:	THE CUSTOM PRESCRIPTION SHOPPE, LLC
Jurisdiction:	WASHINGTON
Entity Type:	WA LIMITED LIABILITY COMPANY
Category:	DOMESTIC ENTITY
Status:	Active
Formation/ Registration Date:	March 27th 2003
Expiration date:	31 Mar 2026
UBI Number:	602 283 320
ZIP code:	98248
City:	Ferndale
County:	WHATCOM
Home State:	WASHINGTON
Principal Office Street Address:	5917 PORTAL WAY, FERNDALE, WA, 98248, UNITED STATES
Supporting healthcare providers fighting with COVID-19:	$347

Contact Details

E-Mail:	KFARIS@CRXSHOPPE.COM
Phone Number:	+1 360-685-4282

Nature of Business

Retail

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Registered Agent Information

Name	Role	Address
JAY SOLOMON	Registered Agent	201 SEA PINES LN, BELLINGHAM, WA, 98229-9364, UNITED STATES

Key Officers & Management

Name	Role	Address
KEVIN FARIS	Governing Person	720 CROSS ST, BELLINGHAM, WA, 98229-8989, UNITED STATES

Links between entities

Type:

Headquarter of

Company Number:

3165881

State:

NEW YORK

NEW YORK profile:

THE CUSTOM PRESCRIPTION SHOPPE, LLC (NY)

National Provider Identifier

NPI Number:

1912739590

Certification Date:

2024-08-14

Link:

View on NPI website

Authorized Person:

Name:

KEVIN FARIS

Role:

CEO

Phone:

3606854282

Taxonomy:

Selected Taxonomy:

3336L0003X - Long Term Care Pharmacy

Is Primary:

Yes

Contacts:

Phone:

+1 360-685-4282

Fax:

3606854283

Form 5500 Series

Employer Identification Number (EIN):

200020000

Plan Year:

2015

Number Of Participants:

27

Plan Name:

401(K)

Sponsor's telephone number:

3606854242

File:

Plan Year:

2015

Number Of Participants:

27

Plan Name:

401(K)

Sponsor's telephone number:

3606854270

File:

Plan Year:

2014

Number Of Participants:

45

Plan Name:

401(K)

Sponsor's telephone number:

3606854270

File:

Plan Administrator / Signatory:

SARAH PITTS(Plan administrator)

Plan Year:

2013

Number Of Participants:

49

Plan Name:

401(K)

Sponsor's telephone number:

3606854270

Plan Administrator / Signatory:

JAY SOLOMON(Plan administrator)

Plan Year:

2013

Number Of Participants:

49

Plan Name:

401(K)

Sponsor's telephone number:

3606854270

File:

Plan Administrator / Signatory:

SARAH PITTS(Plan administrator)

Paycheck Protection Program

Jobs Reported:

11

Initial Approval Amount:

$87,432

Date Approved:

2020-04-07

Loan Status:

Paid in Full

SBA Guaranty Percentage:

100

Current Approval Amount:

$87,432

Race:

Unanswered

Ethnicity:

Unknown/NotStated

Gender:

Unanswered

Veteran:

Unanswered

Forgiveness Amount:

$88,459.63

Servicing Lender:

Heritage Bank

Use of Proceeds:

Payroll: $87,432

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