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MEDICAL SUPPLY STORE #1, INC.

MEDICAL SUPPLY STORE #1, INC.

Company Details

Entity Name:	MEDICAL SUPPLY STORE #1, INC.
Jurisdiction:	FLORIDA
Filing Type:	Domestic Profit
Status:	Inactive
Date Filed:	26 Feb 2004 (21 years ago)
Date of dissolution:	24 May 2010 (15 years ago)
Last Event:	ADMIN DISSOLUTION FOR REGISTERED AGENT
Event Date Filed:	24 May 2010 (15 years ago)
Document Number:	P04000036382
FEI/EIN Number	562438120
Address:	7114 N. UNIVERSITY DRIVE, TAMARAC, FL, 33321, US
Mail Address:	7309 NW 64 CT., TAMARAC, FL, 33321
ZIP code:	33321
County:	Broward
Place of Formation:	FLORIDA

National Provider Identifier

NPI

Enumeration Date

Last Update Date

Mailing Address

Practice Location Address

1851486674

2006-10-04

2009-03-03

1831 N UNIVERSITY DR, CORAL SPRINGS, FL, 330716001, US

Contacts

Phone	+1 954-933-9137
Fax	9547529447

Authorized person

Name	MR. BEN ZION KUNCMAN
Role	CEO
Phone	9549339137

Taxonomy

Taxonomy Code	332B00000X - Durable Medical Equipment & Medical Supplies
License Number	1313370
State	FL
Is Primary	Yes

Other Provider Identifiers

Issuer	BCBS
Number	R9710
State	FL

Manager

Name	Role	Address
DEONARINE NISHA	Manager	7114 N. UNIVERSITY DRIVE, TAMARAC, FL, 33321

Events

Event Type	Filed Date	Value	Description
ADMIN DISSOLUTION FOR REGISTERED AGENT	2010-05-24	No data	No data
CANCEL ADM DISS/REV	2009-10-07	No data	No data
CHANGE OF PRINCIPAL ADDRESS	2009-10-07	7114 N. UNIVERSITY DRIVE, TAMARAC, FL 33321	No data
ADMIN DISSOLUTION FOR ANNUAL REPORT	2009-09-25	No data	No data
CHANGE OF MAILING ADDRESS	2009-09-23	7114 N. UNIVERSITY DRIVE, TAMARAC, FL 33321	No data
CANCEL ADM DISS/REV	2008-11-04	No data	No data
ADMIN DISSOLUTION FOR ANNUAL REPORT	2008-09-26	No data	No data

Debts

Document Number	Status	Case Number	Name of Court	Date of Entry	Expiration Date	Amount Due	Plaintiff
J09000994086	TERMINATED	1000000102533	45856 1955	2008-12-10	2029-03-25	$ 20.00	STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3111 N UNIVERSITY DR STE 501, CORAL SPRINGS FL330655096
J09000208461	TERMINATED	1000000102533	45856 1955	2008-12-10	2029-01-22	$ 1,156.53	STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3111 N UNIVERSITY DR STE 501, CORAL SPRINGS FL330655096
J09000444538	TERMINATED	1000000102531	45857 833	2008-12-10	2029-01-28	$ 1,446.34	STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3111 N UNIVERSITY DR STE 501, CORAL SPRINGS FL330655096
J09000444553	ACTIVE	1000000102533	45856 1955	2008-12-10	2029-01-28	$ 1,156.53	STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3111 N UNIVERSITY DR STE 501, CORAL SPRINGS FL330655096
J09000208446	TERMINATED	1000000102531	45857 833	2008-12-10	2029-01-22	$ 1,446.34	STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3111 N UNIVERSITY DR STE 501, CORAL SPRINGS FL330655096
J09000526920	TERMINATED	1000000102533	45856 1955	2008-12-10	2029-02-04	$ 20.00	STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3111 N UNIVERSITY DR STE 501, CORAL SPRINGS FL330655096
J09000601467	TERMINATED	1000000102533	45856 1955	2008-12-10	2029-02-11	$ 20.00	STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3111 N UNIVERSITY DR STE 501, CORAL SPRINGS FL330655096
J09000676501	TERMINATED	1000000102533	45856 1955	2008-12-10	2029-02-18	$ 20.00	STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3111 N UNIVERSITY DR STE 501, CORAL SPRINGS FL330655096
J09000751759	TERMINATED	1000000102533	45856 1955	2008-12-10	2014-02-25	$ 20.00	STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3111 N UNIVERSITY DR STE 501, CORAL SPRINGS FL330655096
J09000809813	TERMINATED	1000000102533	45856 1955	2008-12-10	2029-03-05	$ 20.00	STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3111 N UNIVERSITY DR STE 501, CORAL SPRINGS FL330655096
J09000869700	TERMINATED	1000000102533	45856 1955	2008-12-10	2029-03-11	$ 20.00	STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3111 N UNIVERSITY DR STE 501, CORAL SPRINGS FL330655096
J09000927565	TERMINATED	1000000102533	45856 1955	2008-12-10	2029-03-18	$ 20.00	STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3111 N UNIVERSITY DR STE 501, CORAL SPRINGS FL330655096
J07000396872	TERMINATED	1000000066510	44848 563	2007-11-28	2027-12-05	$ 4,945.28	STATE OF FLORIDA, DEPARTMENT OF REVENUE, CORAL SPRINGS SERVICE CENTER, 3111 N UNIVERSITY DR STE 501, CORAL SPRINGS FL330655096

Documents

Name	Date
Admin. Diss. for Reg. Agent	2010-05-24
Reg. Agent Resignation	2010-02-11
REINSTATEMENT	2009-10-07
Reg. Agent Change	2009-09-23
Off/Dir Resignation	2009-09-23
REINSTATEMENT	2008-11-04
Off/Dir Resignation	2008-09-08
Off/Dir Resignation	2007-11-16
ANNUAL REPORT	2007-03-23
ANNUAL REPORT	2006-02-15
ANNUAL REPORT	2005-01-31
Reg. Agent Change	2004-05-19
Domestic Profit	2004-02-26

Date of last update: 01 Feb 2025

Sources: Florida Department of State