| Entity Name: | BIOSCRIP PHARMACY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Foreign Profit |
| Status: | Inactive |
| Date Filed: | 12 Jun 1996 (29 years ago) |
| Branch of: | BIOSCRIP PHARMACY, INC., MINNESOTA (Company Number a00a4b1b-aad4-e011-a886-001ec94ffe7f) |
| Document Number: | F96000002955 |
| FEI/EIN Number | 411841437 |
| Mail Address: | 100 CLEARBROOK ROAD, ELMSFORD, NY, 10523 |
| Address: | 10050 CROSSTOWN CIRCLE, SUITE 300, EDEN PRAIRIE, MN, 55344, US |
| Place of Formation: | MINNESOTA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881698355 | 2005-06-13 | 2011-09-13 | 10050 CROSSTOWN CIR, STE 300, EDEN PRAIRIE, MN, 553443374, US | 3111 45TH ST, SUITES 9 & 10, WEST PALM BEACH, FL, 334071974, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 800-753-5995 |
| Fax | 9523526698 |
| Phone | +1 561-683-0001 |
Authorized person
| Name | JAMES MELANCON |
| Role | VICE PRESIDENT |
| Phone | 9174496939 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH0015110 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 10542610001 |
| State | FL |
| Issuer | MEDICAID |
| Number | 105426100 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| SMITH RICHARD M | Chief Executive Officer | 100 Clearbrook Road, Elmsford,, NY, 10523 |
| Name | Role | Address |
|---|---|---|
| SMITH RICHARD M | Director | 100 Clearbrook Road, Elmsford,, NY, 10523 |
| SEAH KIMBERLEE | Director | 100 Clearbrook Road, Elmsford, NY, 10523 |
| Name | Role | Address |
|---|---|---|
| SEAH KIMBERLEE | Secretary | 100 Clearbrook Road, Elmsford, NY, 10523 |
| Name | Role | Address |
|---|---|---|
| BOGUSZ PATRICIA | Treasurer | 10050 CROSSTOWN CIRCLE, SUITE 300, EDEN PRAIRIE, MN, 55344 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| WITHDRAWAL | 2014-02-06 | No data | No data |
| CANCEL ADM DISS/REV | 2006-11-21 | No data | No data |
| REVOKED FOR ANNUAL REPORT | 2006-09-15 | No data | No data |
| NAME CHANGE AMENDMENT | 2005-11-30 | BIOSCRIP PHARMACY, INC. | No data |
| REINSTATEMENT | 2005-10-13 | No data | No data |
| REVOKED FOR ANNUAL REPORT | 2005-09-16 | No data | No data |
Date of last update: 02 Jan 2025
Sources: Florida Department of State
