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  5. PANCARE OF FLORIDA, INC.

PANCARE OF FLORIDA, INC.

Company Details

Entity Name: PANCARE OF FLORIDA, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Non-Profit
Status: Active
Date Filed: 17 Mar 2003 (22 years ago)
Document Number: N03000002427
FEI/EIN Number 912189932
Address: 403 East 11th Street, PANAMA CITY, FL, 32401, US
Mail Address: 403 East 11th Street, PANAMA CITY, FL, 32401, US
ZIP code: 32401
County: Bay
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1326872060 2024-08-27 2024-10-11 2235 E 15TH ST, PANAMA CITY, FL, 324056023, US 401 CECIL G COSTIN SR BLVD, PORT ST JOE, FL, 324561928, US

Contacts
Phone +1 850-818-0455
Fax 8502153354
Phone +1 850-229-1043
Fax 8502291104

Authorized person
Name LORI BARTON
Role PHARMACY DIRECTOR
Phone 8508180455

Taxonomy
Taxonomy Code 3336C0003X - Community/Retail Pharmacy
Is Primary Yes

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
403(B) THRIFT PLAN OF PANCARE OF FLORIDA, INC. 2016 912189932 2017-07-27 PANCARE OF FLORIDA, INC. 54
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 541990
Sponsor’s telephone number 8508724128
Plan sponsor’s address 403 E 11 STREET, PANAMA CITY, FL, 32401

Signature of
Role Plan administrator
Date 2017-07-27
Name of individual signing WILLIAM MARK GERSPACHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2017-07-27
Name of individual signing WILLIAM MARK GERSPACHER
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF PANCARE OF FLORIDA, INC. 2015 912189932 2016-10-17 PANCARE OF FLORIDA, INC. 49
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 541990
Sponsor’s telephone number 8508724128
Plan sponsor’s address 431 W OAK AVE, PANAMA CITY, FL, 32401

Signature of
Role Plan administrator
Date 2016-10-17
Name of individual signing WILLIAM MARK GERSPACHER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-10-17
Name of individual signing WILLIAM MARK GERSPACHER
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF PANCARE OF FLORIDA, INC. 2014 912189932 2015-06-17 PANCARE OF FLORIDA, INC. 25
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 541990
Sponsor’s telephone number 8508724128
Plan sponsor’s address 431 W OAK AVE, PANAMA CITY, FL, 32401

Signature of
Role Plan administrator
Date 2015-06-17
Name of individual signing TOM E BREWSTER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2015-06-17
Name of individual signing TOM E BREWSTER
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF PANCARE OF FLORIDA, INC. 2013 912189932 2014-05-21 PANCARE OF FLORIDA, INC. 28
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 541990
Sponsor’s telephone number 8508724128
Plan sponsor’s address 431 W OAK AVE, PANAMA CITY, FL, 32401

Signature of
Role Plan administrator
Date 2014-05-21
Name of individual signing TOM E BREWSTER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-05-21
Name of individual signing TOM E BREWSTER
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF PANCARE OF FLORIDA, INC. 2012 912189932 2013-06-27 PANCARE OF FLORIDA, INC. 33
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 541990
Sponsor’s telephone number 8508724128
Plan sponsor’s address 431 W OAK AVE, PANAMA CITY, FL, 32401

Signature of
Role Plan administrator
Date 2013-06-27
Name of individual signing TOM E. BREWSTER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2013-06-27
Name of individual signing TOM E. BREWSTER
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF PANCARE OF FLORIDA, INC. 2011 912189932 2012-06-15 PANCARE OF FLORIDA, INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 541990
Sponsor’s telephone number 8508724128
Plan sponsor’s address 431 W OAK AVE, PANAMA CITY, FL, 32401

Plan administrator’s name and address
Administrator’s EIN 912189932
Plan administrator’s name PANCARE OF FLORIDA, INC.
Plan administrator’s address 431 W OAK AVE, PANAMA CITY, FL, 32401
Administrator’s telephone number 8508724128

Signature of
Role Plan administrator
Date 2012-06-15
Name of individual signing TOM E BREWSTER, CFO
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2012-06-15
Name of individual signing TOM E BREWSTER, CFO
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF PANCARE OF FLORIDA, INC. 2010 912189932 2011-07-12 PANCARE OF FLORIDA, INC. 11
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 541990
Sponsor’s telephone number 8508724128
Plan sponsor’s address 431 W OAK AVE, PANAMA CITY, FL, 32401

Plan administrator’s name and address
Administrator’s EIN 912189932
Plan administrator’s name PANCARE OF FLORIDA, INC.
Plan administrator’s address 431 W OAK AVE, PANAMA CITY, FL, 32401
Administrator’s telephone number 8508724128

Signature of
Role Plan administrator
Date 2011-07-12
Name of individual signing R MICHAEL HILL
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2011-07-12
Name of individual signing R MICHAEL HILL
Valid signature Filed with incorrect/unrecognized electronic signature
403(B) THRIFT PLAN OF PANCARE OF FLORIDA, INC. 2010 912189932 2011-07-28 PANCARE OF FLORIDA, INC. 11
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 541990
Sponsor’s telephone number 8508724128
Plan sponsor’s address 431 W OAK AVE, PANAMA CITY, FL, 32401

Plan administrator’s name and address
Administrator’s EIN 912189932
Plan administrator’s name PANCARE OF FLORIDA, INC.
Plan administrator’s address 431 W OAK AVE, PANAMA CITY, FL, 32401
Administrator’s telephone number 8508724128

Signature of
Role Plan administrator
Date 2011-07-28
Name of individual signing TOM BREWSTER
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2011-07-28
Name of individual signing TOM BREWSTER
Valid signature Filed with incorrect/unrecognized electronic signature
403(B) THRIFT PLAN OF PANCARE OF FLORIDA, INC. 2010 912189932 2011-07-28 PANCARE OF FLORIDA, INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 541990
Sponsor’s telephone number 8508724128
Plan sponsor’s address 431 W OAK AVE, PANAMA CITY, FL, 32401

Plan administrator’s name and address
Administrator’s EIN 912189932
Plan administrator’s name PANCARE OF FLORIDA, INC.
Plan administrator’s address 431 W OAK AVE, PANAMA CITY, FL, 32401
Administrator’s telephone number 8508724128

Signature of
Role Plan administrator
Date 2011-07-28
Name of individual signing TOM BREWSTER
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2011-07-28
Name of individual signing TOM BREWSTER
Valid signature Filed with authorized/valid electronic signature
403(B) THRIFT PLAN OF PANCARE OF FLORIDA, INC. 2010 912189932 2011-07-12 PANCARE OF FLORIDA, INC. 11
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 541990
Sponsor’s telephone number 8508724128
Plan sponsor’s address 431 W OAK AVE, PANAMA CITY, FL, 32401

Plan administrator’s name and address
Administrator’s EIN 912189932
Plan administrator’s name PANCARE OF FLORIDA, INC.
Plan administrator’s address 431 W OAK AVE, PANAMA CITY, FL, 32401
Administrator’s telephone number 8508724128

Signature of
Role Plan administrator
Date 2011-07-12
Name of individual signing MIKE HILL
Valid signature Filed with incorrect/unrecognized electronic signature
Role Employer/plan sponsor
Date 2011-07-12
Name of individual signing MIKE HILL
Valid signature Filed with incorrect/unrecognized electronic signature

Agent

Name Role Address
THOMPSON ROBERT Agent 403 East 11th Street, PANAMA CITY, FL, 32401

Chief Executive Officer

Name Role Address
THOMPSON ROBERT Chief Executive Officer 403 E 11TH ST, PANAMA CITY, FL, 32401

Secretary

Name Role Address
HIEP LE H Secretary 1103 N. Haven Circle, Lynn Haven, FL, 32444

Treasurer

Name Role Address
HIEP LE H Treasurer 1103 N. Haven Circle, Lynn Haven, FL, 32444

Director

Name Role Address
HIEP LE H Director 1103 N. Haven Circle, Lynn Haven, FL, 32444

Chairman

Name Role Address
Hardy Ronald Chairman 781 Choctawhatchee, Bruce, FL, 32455

Vice Chairman

Name Role Address
Ramsey Willie Vice Chairman 1004 Marvin Avenue, Port St. Joe, FL, 32456

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G24000153555 GOLDEN PHARMACY ACTIVE 2024-12-18 2029-12-31 No data 403 EAST 11TH STREET, PANAMA CITY, FL, 32401
G19000125210 PANCARE HEALTH EXPIRED 2019-11-22 2024-12-31 No data 403 EAST 11TH STREET, PANAMA CITY, FL, 32401
G09000143416 COMMUNITY HEALTH CNETER-WALTON COUNTY EXPIRED 2009-08-07 2014-12-31 No data 431 OAK AVENUE, PANAMA CITY, FL, 32401

Events

Event Type Filed Date Value Description
REGISTERED AGENT NAME CHANGED 2023-02-10 THOMPSON, ROBERT No data
REGISTERED AGENT ADDRESS CHANGED 2020-04-13 403 East 11th Street, PANAMA CITY, FL 32401 No data
CHANGE OF MAILING ADDRESS 2017-11-01 403 East 11th Street, PANAMA CITY, FL 32401 No data
CHANGE OF PRINCIPAL ADDRESS 2016-06-28 403 East 11th Street, PANAMA CITY, FL 32401 No data

Documents

Name Date
ANNUAL REPORT 2024-03-05
ANNUAL REPORT 2023-02-10
ANNUAL REPORT 2022-04-28
ANNUAL REPORT 2021-02-12
ANNUAL REPORT 2020-04-13
ANNUAL REPORT 2019-05-29
ANNUAL REPORT 2018-06-07
ANNUAL REPORT 2017-06-06
ANNUAL REPORT 2016-06-28
ANNUAL REPORT 2015-04-30

Related by officers

THOMPSON ROBERT

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Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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