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  5. DELRAY SHORES PHARMACY, INC.

DELRAY SHORES PHARMACY, INC.

Company Details

Entity Name: DELRAY SHORES PHARMACY, INC.
Jurisdiction: FLORIDA
Filing Type: Florida Profit Corporation
Status: Active
Date Filed: 21 Mar 1977 (48 years ago)
Document Number: 529746
FEI/EIN Number 59-1723387
Address: 124 NE 5th Avenue, DELRAY BEACH, FL 33483
Mail Address: 124 NE 5th Avenue, DELRAY BEACH, FL 33483
ZIP code: 33483
County: Palm Beach
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1912086687 2006-11-03 2020-11-24 124 NE 5TH AVE, DELRAY BEACH, FL, 334835429, US 124 NE 5TH AVE, DELRAY BEACH, FL, 33483, US

Contacts
Phone +1 561-272-2124
Fax 5612722830

Authorized person
Name THOMAS DILDINE
Role PRESIDENT, PIC
Phone 5612722124

Taxonomy
Taxonomy Code 333600000X - Pharmacy
Is Primary No
Taxonomy Code 3336C0003X - Community/Retail Pharmacy
License Number PH6174
State FL
Is Primary Yes
Taxonomy Code 3336C0004X - Compounding Pharmacy
Is Primary No

Other Provider Identifiers
Issuer MEDICAID
Number 103438300
State FL
Issuer PK
Number 2009655

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
DELRAY SHORES PHARMACY 401(K) PLAN 2023 591723387 2024-10-08 DELRAY SHORES PHARMACY, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 446110
Sponsor’s telephone number 5612722124
Plan sponsor’s address 124 NE 5TH AVE, DELRAY BEACH, FL, 33483
DELRAY SHORES PHARMACY 401(K) PLAN 2022 591723387 2023-07-06 DELRAY SHORES PHARMACY, INC. 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 446110
Sponsor’s telephone number 5612722124
Plan sponsor’s address 124 NE 5TH AVE, DELRAY BEACH, FL, 33483
DELRAY SHORES PHARMACY 401(K) PLAN 2021 591723387 2022-09-30 DELRAY SHORES PHARMACY, INC. 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 446110
Sponsor’s telephone number 5612722124
Plan sponsor’s address 124 NE 5TH AVE, DELRAY BEACH, FL, 33483
DELRAY SHORES PHARMACY 401(K) PLAN 2020 591723387 2021-10-05 DELRAY SHORES PHARMACY, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 446110
Sponsor’s telephone number 5612722124
Plan sponsor’s address 124 NE 5TH AVE, DELRAY BEACH, FL, 33483
DELRAY SHORES PHARMACY 401(K) PLAN 2019 591723387 2020-09-25 DELRAY SHORES PHARMACY, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 446110
Sponsor’s telephone number 5612722124
Plan sponsor’s address 124 NE 5TH AVE, DELRAY BEACH, FL, 33483
DELRAY SHORES PHARMACY 401(K) PLAN 2018 591723387 2019-06-19 DELRAY SHORES PHARMACY, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 446110
Sponsor’s telephone number 5612722124
Plan sponsor’s address 124 NE 5TH AVE, DELRAY BEACH, FL, 33483
DELRAY SHORES PHARMACY 401(K) PLAN 2017 591723387 2018-05-30 DELRAY SHORES PHARMACY, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 446110
Sponsor’s telephone number 5612722124
Plan sponsor’s address 124 NE 5TH AVE, DELRAY BEACH, FL, 33483
DELRAY SHORES PHARMACY 401(K) PLAN 2016 591723387 2017-11-06 DELRAY SHORES PHARMACY, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 446110
Sponsor’s telephone number 5612722124
Plan sponsor’s address 601 NORTH CONGRESS AVE, SUITE 407, DELRAY, FL, 33445
DELRAY SHORES PHARMACY 401(K) PLAN 2016 591723387 2017-11-06 DELRAY SHORES PHARMACY, INC. 8
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 446110
Sponsor’s telephone number 5612722124
Plan sponsor’s address 601 NORTH CONGRESS AVE, SUITE 407, DELRAY, FL, 33445
DELRAY SHORES PHARMACY 401(K) PLAN 2015 591723387 2016-06-28 DELRAY SHORES PHARMACY, INC. 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 446110
Sponsor’s telephone number 5612722124
Plan sponsor’s address 601 NORTH CONGRESS AVE, SUITE 407, DELRAY, FL, 33445

Agent

Name Role Address
DILDINE, THOMAS L, Jr. Agent 124 NE 5th Avenue, DELRAY BEACH, FL 33483

President

Name Role Address
DILDINE, THOMAS L, Jr. President 124 NE 5th Avenue, DELRAY BEACH, FL 33483

Treasurer

Name Role Address
DILDINE, THOMAS L, Jr. Treasurer 124 NE 5th Avenue, DELRAY BEACH, FL 33483

Vice President

Name Role Address
DILDINE, RHYAN Vice President 124 NE 5th Avenue, DELRAY BEACH, FL 33483

Secretary

Name Role Address
DILDINE, RHYAN Secretary 124 NE 5th Avenue, DELRAY BEACH, FL 33483

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2018-01-30 124 NE 5th Avenue, DELRAY BEACH, FL 33483 No data
CHANGE OF MAILING ADDRESS 2018-01-30 124 NE 5th Avenue, DELRAY BEACH, FL 33483 No data
REGISTERED AGENT ADDRESS CHANGED 2018-01-30 124 NE 5th Avenue, DELRAY BEACH, FL 33483 No data
REGISTERED AGENT NAME CHANGED 2014-03-16 DILDINE, THOMAS L, Jr. No data

Documents

Name Date
ANNUAL REPORT 2024-04-25
ANNUAL REPORT 2023-01-23
ANNUAL REPORT 2022-01-27
ANNUAL REPORT 2021-01-27
ANNUAL REPORT 2020-02-22
ANNUAL REPORT 2019-04-29
ANNUAL REPORT 2018-01-30
ANNUAL REPORT 2017-02-16
ANNUAL REPORT 2016-03-08
AMENDED ANNUAL REPORT 2015-09-23

Related by officers

No related officers

Related by address

No related companies by address

Date of last update: 05 Feb 2025

Sources: Florida Department of State

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