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  5. COCOA BEACH DISCOUNT PHARMACY LLC

COCOA BEACH DISCOUNT PHARMACY LLC

Company Details

Entity Name: COCOA BEACH DISCOUNT PHARMACY LLC
Jurisdiction: FLORIDA
Filing Type: Florida Limited Liability Co.
Status: Active
Date Filed: 24 May 2010 (15 years ago)
Document Number: L10000055763
FEI/EIN Number 272664707
Address: 291 W. COCOA BEACH CAUSEWAY, COCOA BEACH, FL, 32931, US
Mail Address: 291 W. COCOA BEACH CAUSEWAY, COCOA BEACH, FL, 32931, US
ZIP code: 32931
County: Brevard
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1235444183 2010-08-16 2010-11-02 291 W COCOA BEACH CSWY, COCOA BEACH, FL, 329313529, US 291 W COCOA BEACH CSWY, COCOA BEACH, FL, 329313529, US

Contacts
Phone +1 321-799-2030
Fax 3217992050

Authorized person
Name HETALBEN PATEL
Role PHARMACY MANAGER
Phone 3217992030

Taxonomy
Taxonomy Code 333600000X - Pharmacy
Is Primary No
Taxonomy Code 3336C0003X - Community/Retail Pharmacy
License Number PH24812
State FL
Is Primary Yes
Taxonomy Code 3336C0004X - Compounding Pharmacy
Is Primary No

Other Provider Identifiers
Issuer MEDICAID
Number 002760200
State FL
Issuer NCPDP PROVIDER IDENTIFICATION NUMBER
Number 5701354

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
COCOA BEACH DISCOUNT PHARMACY, LLC 401(K) PLAN 2022 272664707 2023-10-13 COCOA BEACH DISCOUNT PHARMACY, LLC 26
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 446110
Sponsor’s telephone number 3217992030
Plan sponsor’s address 291 W. COCOA BEACH CAUSEWAY, COCOA BEACH, FL, 32931
COCOA BEACH DISCOUNT PHARMACY, LLC 401(K) PLAN 2021 272664707 2022-08-03 COCOA BEACH DISCOUNT PHARMACY, LLC 24
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 446110
Sponsor’s telephone number 3217992030
Plan sponsor’s address 291 W. COCOA BEACH CAUSEWAY, COCOA BEACH, FL, 32931
COCOA BEACH DISCOUNT PHARMACY, LLC 401(K) PLAN 2020 272664707 2021-07-31 COCOA BEACH DISCOUNT PHARMACY, LLC 23
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 446110
Sponsor’s telephone number 3217992030
Plan sponsor’s address 291 W. COCOA BEACH CAUSEWAY, COCOA BEACH, FL, 32931
COCOA BEACH DISCOUNT PHARMACY, LLC 401(K) PLAN 2019 272664707 2020-08-19 COCOA BEACH DISCOUNT PHARMACY, LLC 20
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 446110
Sponsor’s telephone number 3217992030
Plan sponsor’s address 291 W. COCOA BEACH CAUSEWAY, COCOA BEACH, FL, 32931
COCOA BEACH DISCOUNT PHARMACY, LLC 401(K) PLAN 2018 272664707 2019-07-22 COCOA BEACH DISCOUNT PHARMACY, LLC 19
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 446110
Sponsor’s telephone number 3217992030
Plan sponsor’s address 291 W. COCOA BEACH CAUSEWAY, COCOA BEACH, FL, 32931
COCOA BEACH DISCOUNT PHARMACY, LLC 401(K) PLAN 2017 272664707 2018-07-18 COCOA BEACH DISCOUNT PHARMACY, LLC 16
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 446110
Sponsor’s telephone number 3217992030
Plan sponsor’s address 291 W. COCOA BEACH CAUSEWAY, COCOA BEACH, FL, 32931

Signature of
Role Plan administrator
Date 2018-07-18
Name of individual signing HITESH PATEL
Valid signature Filed with authorized/valid electronic signature
COCOA BEACH DISCOUNT PHARMACY, LLC 401(K) PLAN 2016 272664707 2017-07-19 COCOA BEACH DISCOUNT PHARMACY, LLC 14
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 446110
Sponsor’s telephone number 3217992030
Plan sponsor’s address 291 W. COCOA BEACH CAUSEWAY, COCOA BEACH, FL, 32931

Signature of
Role Plan administrator
Date 2017-07-19
Name of individual signing HITESH PATEL
Valid signature Filed with authorized/valid electronic signature
COCOA BEACH DISCOUNT PHARMACY, LLC 401(K) PLAN 2015 272664707 2016-09-13 COCOA BEACH DISCOUNT PHARMACY, LLC 13
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 446110
Sponsor’s telephone number 3217992030
Plan sponsor’s address 291 W. COCOA BEACH CAUSEWAY, COCOA BEACH, FL, 32931

Signature of
Role Plan administrator
Date 2016-09-13
Name of individual signing HITESH PATEL
Valid signature Filed with authorized/valid electronic signature
COCOA BEACH DISCOUNT PHARMACY, LLC 401(K) PLAN 2014 272664707 2015-07-13 COCOA BEACH DISCOUNT PHARMACY, LLC 11
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 446110
Sponsor’s telephone number 3217992030
Plan sponsor’s address 291 W. COCOA BEACH CAUSEWAY, COCOA BEACH, FL, 32931

Signature of
Role Plan administrator
Date 2015-07-13
Name of individual signing HITESH PATEL
Valid signature Filed with authorized/valid electronic signature
COCOA BEACH DISCOUNT PHARMACY, LLC 401(K) PLAN 2013 272664707 2014-08-21 COCOA BEACH DISCOUNT PHARMACY, LLC 8
File View Page
Three-digit plan number (PN) 002
Effective date of plan 2012-01-01
Business code 446110
Sponsor’s telephone number 3217992030
Plan sponsor’s address 291 W. COCOA BEACH CAUSEWAY, COCOA BEACH, FL, 32931

Signature of
Role Plan administrator
Date 2014-08-21
Name of individual signing REBECCA TORRES
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
PATEL HETALBEN S Agent 291 W. COCOA BEACH CAUSEWAY, COCOA BEACH, FL, 32931

Auth

Name Role Address
Patel Hetalben S Auth 291 W. COCOA BEACH CAUSEWAY, COCOA BEACH, FL, 32931
Patel Darshana H Auth 291 W. COCOA BEACH CAUSEWAY, COCOA BEACH, FL, 32931

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G10000062730 COCOA BEACH DISCOUNT PHARMACY EXPIRED 2010-07-07 2015-12-31 No data 291 W COCOA BEACH CSWY, COCOA BEACH, FL, 32931

Documents

Name Date
ANNUAL REPORT 2024-02-24
ANNUAL REPORT 2023-01-31
ANNUAL REPORT 2022-01-29
ANNUAL REPORT 2021-02-26
ANNUAL REPORT 2020-01-12
ANNUAL REPORT 2019-04-29
ANNUAL REPORT 2018-04-06
ANNUAL REPORT 2017-03-17
ANNUAL REPORT 2016-04-22
ANNUAL REPORT 2015-01-14

Related by officers

PATEL HETALBEN S

HEARTLAND DISCOUNT PHARMACY, LLC APEX CARE PHARMACY LLC REHANVI REALTY, LLC APEXCARE MANAGEMENT LLC

Related by address

No related companies by address

Date of last update: 01 Feb 2025

Sources: Florida Department of State

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