| Entity Name: | FLETCHER'S MEDICAL SUPPLIES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 08 Mar 1983 (42 years ago) |
| Document Number: | G26788 |
| FEI/EIN Number | 592288055 |
| Address: | 220 W. GERMANTOWN PIKE, SUITE 250, PLYMOUTH MEETING, PA, 19462, US |
| Mail Address: | 220 W. GERMANTOWN PIKE, SUITE 250, PLYMOUTH MEETING, PA, 19462, US |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1780139741 | 2016-08-19 | 2016-09-29 | 6851 DISTRIBUTION AVE S, JACKSONVILLE, FL, 322562742, US | 641 W 4TH ST, JACKSONVILLE, FL, 322096624, US | |||||||||||||||
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| Phone | +1 904-387-4481 |
| Fax | 8663817235 |
Authorized person
| Name | MR. WILLIAM DAVID FLETCHER |
| Role | PRESIDENT/OWNER |
| Phone | 9043874481 |
Taxonomy
| Taxonomy Code | 3140N1450X - Pediatric Skilled Nursing Facility |
| Is Primary | Yes |
| LEI number | Registered As | Jurisdiction Of Formation | General Category | Entity Status | Entity created at | |||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 5493006SSSH3B6GUA245 | G26788 | US-FL | GENERAL | ACTIVE | No data | |||||||||||||||||||
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| Legal | C/O FLETCHER, WILLIAM D, 6851 DISTRIBUTION AVENUE South, JACKSONVILLE, US-FL, US, 32256 |
| Headquarters | 6851 South Distribution Avenue, Jacksonville, US-FL, US, 32256 |
Registration details
| Registration Date | 2017-12-05 |
| Last Update | 2023-08-04 |
| Status | LAPSED |
| Next Renewal | 2020-10-07 |
| LEI Issuer | 5493001KJTIIGC8Y1R12 |
| Corroboration Level | FULLY_CORROBORATED |
| Data Validated As | G26788 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| FLETCHER'S MEDICAL SUPPLIES, INC. GROUP LIFE & ACCIDENTAL DEATH & DISMEMBERMENT | 2021 | 592288055 | 2022-04-10 | FLETCHER'S MEDICAL SUPPLIES, INC. | 129 | |||||||||||||||||||||||||||||||||||||||||
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| Active participants | 94 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 0 |
Signature of
| Role | Plan administrator |
| Date | 2022-04-10 |
| Name of individual signing | JANET BARRETT |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 501 |
| Effective date of plan | 2018-01-01 |
| Business code | 621610 |
| Sponsor’s telephone number | 9043874481 |
| Plan sponsor’s mailing address | 6851 DISTRIBUTION AVE S, JACKSONVILLE, FL, 322562742 |
| Plan sponsor’s address | 6851 DISTRIBUTION AVE S, JACKSONVILLE, FL, 322562742 |
Number of participants as of the end of the plan year
| Active participants | 129 |
| Retired or separated participants receiving benefits | 0 |
| Other retired or separated participants entitled to future benefits | 0 |
Signature of
| Role | Plan administrator |
| Date | 2021-05-13 |
| Name of individual signing | DAVID FLETCHER |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2021-05-13 |
| Name of individual signing | DAVID FLETCHER |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role |
|---|---|
| UNITED CORPORATE SERVICES, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| Russalesi Wendy | CHIE | 220 W. GERMANTOWN PIKE, SUITE 250, PLYMOUTH MEETING, PA, 19462 |
| Name | Role | Address |
|---|---|---|
| Clemens Jason | Treasurer | 220 W. GERMANTOWN PIKE, SUITE 250, PLYMOUTH MEETING, PA, 19462 |
| Name | Role | Address |
|---|---|---|
| Foster Suzanne | President | 220 W. GERMANTOWN PIKE, SUITE 250, PLYMOUTH MEETING, PA, 19462 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDED AND RESTATEDARTICLES | 2021-09-30 | No data | No data |
| REINSTATEMENT | 2015-12-01 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2015-09-25 | No data | No data |
| AMENDMENT | 2012-12-31 | No data | No data |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
