| Entity Name: | BIG LAKE PHARMACY, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: |
Domestic Profit
BIG LAKE PHARMACY, INC. is structured as a Domestic Profit Corporation, which, in Florida signifies a Profit Corporation (also known as a C-Corporation). This business structure is recognized as a separate legal entity from its owners. This offers shareholders the benefit of limited liability protection, safeguarding their personal assets from the corporation's debts and obligations, and facilitates raising capital through the issuance of stock. In Florida, Domestic Profit Corporations are governed by Title XXXVI, Chapter 607, Florida Statutes – Florida Business Corporation Act. |
| Status: |
Active
The business entity is active. This status indicates that the business is currently operating and compliant with state regulations, suggesting a lower risk profile for lenders and potentially better creditworthiness. |
| Date Filed: | 22 Apr 2002 (23 years ago) |
| Document Number: | P02000043691 |
| FEI/EIN Number |
010676985
Federal Employer Identification (FEI) Number assigned by the IRS. |
| Address: | 203 S.W. PARK STREET, SUITE B, OKEECHOBEE, FL, 34972 |
| Mail Address: | 203 S.W. PARK STREET, SUITE B, OKEECHOBEE, FL, 34972 |
| ZIP code: | 34972 |
| County: | Okeechobee |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1023098803 | 2006-01-18 | 2009-10-09 | 203 SW PARK ST, STE B, OKEECHOBEE, FL, 349724160, US | 203 SW PARK ST, STE B, OKEECHOBEE, FL, 349724160, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 863-763-1339 |
| Fax | 8637631487 |
Authorized person
| Name | STEVEN NELSON |
| Role | CEO/PRES |
| Phone | 8636344002 |
Taxonomy
| Taxonomy Code | 3336I0012X - Institutional Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| License Number | PH18708 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336M0003X - Managed Care Organization Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 031557500 |
| State | FL |
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 1096785 |
| Name | Role | Address |
|---|---|---|
| NELSON STEVEN D | President | 203 S.W. PARK STREET, OKEECHOBEE, FL, 34972 |
| NELSON STEVEN D | Director | 203 S.W. PARK STREET, OKEECHOBEE, FL, 34972 |
| NELSON ANDREA | Vice President | 203 S.W. PARK STREET, OKEECHOBEE, FL, 34972 |
| NELSON ANDREA | Secretary | 203 S.W. PARK STREET, OKEECHOBEE, FL, 34972 |
| NELSON ANDREA | Treasurer | 203 S.W. PARK STREET, OKEECHOBEE, FL, 34972 |
| NELSON ANDREA | Director | 203 S.W. PARK STREET, OKEECHOBEE, FL, 34972 |
| NELSON STEVEN D | Agent | 203 S.W. PARK STREET, OKEECHOBEE, FL, 34972 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| CHANGE OF PRINCIPAL ADDRESS | 2012-03-16 | 203 S.W. PARK STREET, SUITE B, OKEECHOBEE, FL 34972 | - |
| CHANGE OF MAILING ADDRESS | 2012-03-16 | 203 S.W. PARK STREET, SUITE B, OKEECHOBEE, FL 34972 | - |
| REGISTERED AGENT ADDRESS CHANGED | 2012-03-16 | 203 S.W. PARK STREET, OKEECHOBEE, FL 34972 | - |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-04-13 |
| ANNUAL REPORT | 2023-03-03 |
| ANNUAL REPORT | 2022-03-03 |
| ANNUAL REPORT | 2021-03-23 |
| ANNUAL REPORT | 2020-03-09 |
| ANNUAL REPORT | 2019-03-04 |
| ANNUAL REPORT | 2018-02-13 |
| ANNUAL REPORT | 2017-04-13 |
| ANNUAL REPORT | 2016-04-21 |
| ANNUAL REPORT | 2015-03-03 |
Date of last update: 01 Mar 2025
Sources: Florida Department of State
