| Entity Name: | LINCOURT PHARMACY CORP. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 20 Nov 1984 (40 years ago) |
| Document Number: | H30560 |
| FEI/EIN Number | 592471786 |
| Address: | 501 S. Lincoln Avenue, Suite 10, Clearwater, FL, 33756, US |
| Mail Address: | 501 S. Lincoln Avenue, Suite 10, Clearwater, FL, 33756, US |
| ZIP code: | 33756 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881151603 | 2019-02-28 | 2021-04-05 | 501 S LINCOLN AVE STE 10, CLEARWATER, FL, 337565901, US | 501 S LINCOLN AVE STE 10, CLEARWATER, FL, 337565901, US | |||||||||||||||||||||||||
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| Phone | +1 727-479-3048 |
| Fax | 7274793047 |
Authorized person
| Name | MIRALBHAI PATEL |
| Role | PRESIDENT |
| Phone | 7272394304 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 108648600 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LINCOURT PHARMACY CORP 401(K) PROFIT SHARING PLAN & TRUST | 2020 | 592471786 | 2021-06-03 | LINCOURT PHARMACY CORP | 16 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2021-06-03 |
| Name of individual signing | TRACEY WILLIAMS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2017-01-01 |
| Business code | 541990 |
| Sponsor’s telephone number | 7274460302 |
| Plan sponsor’s address | 501 S LINCOLN AVE - STE 10, CLEARWATER, FL, 33756 |
Signature of
| Role | Plan administrator |
| Date | 2020-05-26 |
| Name of individual signing | EDWARD ROJAS |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2017-01-01 |
| Business code | 446110 |
| Sponsor’s telephone number | 7274460302 |
| Plan sponsor’s address | 501 S. LINCOLN AVENUE, SUITE 10, CLEARWATER, FL, 33756 |
Signature of
| Role | Plan administrator |
| Date | 2018-05-24 |
| Name of individual signing | SHERRY OGDEN |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| Desai Ankit ESQ. | Agent | 501 S Lincoln Ave, Clearwater, FL, 33756 |
| Name | Role | Address |
|---|---|---|
| PATEL MIRAL | Manager | 501 S LINCOLN AVENUE #10, CLEARWATER, FL, 33756 |
| DESAI ANKIT M | Manager | 501 S LINCOLN AVENUE #10, CLEARWATER, FL, 33756 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G21000046970 | LINCOURT PHARMACY | ACTIVE | 2021-04-06 | 2026-12-31 | No data | 501 S LINCOLN AVE, CLEARWATER, FL, 33756 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| AMENDMENT | 2020-10-01 | No data | No data |
| REINSTATEMENT | 2019-10-21 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| REINSTATEMENT | 1999-11-19 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 1999-09-24 | No data | No data |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
