| Entity Name: | SYNERGY PHARMACY SERVICES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 20 May 2010 (15 years ago) |
| Date of dissolution: | 27 Sep 2019 (5 years ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2019 (5 years ago) |
| Document Number: | P10000043719 |
| FEI/EIN Number | 272655992 |
| Address: | 31201 US HWY 19N, STE 2, PALM HARBOR, FL, 34684, US |
| Mail Address: | 31201 US HWY 19 N STE 2, PALM HARBOR, FL, 34684 |
| ZIP code: | 34684 |
| County: | Pinellas |
| Place of Formation: | FLORIDA |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | SYNERGY PHARMACY SERVICES, INC., ALABAMA | 000-381-207 | ALABAMA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1336455096 | 2010-08-19 | 2017-02-27 | 31201 US HIGHWAY 19 N STE 2, PALM HARBOR, FL, 346844422, US | 31201 US HIGHWAY 19 N STE 2, PALM HARBOR, FL, 346844422, US | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 888-918-5024 |
| Fax | 8886881659 |
Authorized person
| Name | ANDREW ASSAD |
| Role | PIC |
| Phone | 8889185024 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
| Taxonomy Code | 332BP3500X - Parenteral & Enteral Nutrition Supplies (DME) |
| Is Primary | No |
| Taxonomy Code | 333600000X - Pharmacy |
| License Number | PH27568 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336H0001X - Home Infusion Therapy Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336L0003X - Long Term Care Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336S0011X - Specialty Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 003029600 |
| State | FL |
| Issuer | PK |
| Number | 2126585 |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SYNERGY PHARMACY SERVICES, INC. CASH BALANCE PLAN | 2015 | 272655992 | 2016-10-17 | SYNERGY PHARMACY SERVICES, INC. | 5 | |||||||||||||||||||||||
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| Role | Plan administrator |
| Date | 2016-10-17 |
| Name of individual signing | MICHAEL J. PALSO |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2014-01-01 |
| Business code | 446110 |
| Sponsor’s telephone number | 8889185024 |
| Plan sponsor’s address | 31201 US HWY 19 N., SUITE 2, PALM HARBOR, FL, 34684 |
Signature of
| Role | Plan administrator |
| Date | 2016-10-17 |
| Name of individual signing | MICHAEL J. PALSO |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2014-01-01 |
| Business code | 446110 |
| Sponsor’s telephone number | 8889185024 |
| Plan sponsor’s address | 31201 US HWY 19 N STE 2, PALM HARBOR, FL, 34684 |
Signature of
| Role | Plan administrator |
| Date | 2015-10-13 |
| Name of individual signing | MICHAEL PALSO |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| ASSAD ANDREW W | Agent | 31201 US HWY 19N, PALM HARBOR, FL, 34684 |
| Name | Role | Address |
|---|---|---|
| ASSAD ANDREW W | Vice President | 31201 US HWY 19 N STE 2, PALM HARBOR, FL, 34684 |
| Name | Role | Address |
|---|---|---|
| PALSO MICHAEL J | President | 31201 US HWY 19 N STE 2, PALM HARBOR, FL, 34684 |
| Name | Role | Address |
|---|---|---|
| BOLOS PETER | Director | 31201 US HWY 19 N STE 2, PALM HARBOR, FL, 34684 |
| Name | Role | Address |
|---|---|---|
| BOLOS PETER | Secretary | 31201 US HWY 19 N STE 2, PALM HARBOR, FL, 34684 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2019-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2018-04-19 | 31201 US HWY 19N, STE 2, PALM HARBOR, FL 34684 | No data |
| AMENDMENT | 2013-05-15 | No data | No data |
| CHANGE OF MAILING ADDRESS | 2013-05-15 | 31201 US HWY 19N, STE 2, PALM HARBOR, FL 34684 | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J18000402206 | LAPSED | 8:17-CV-1802-T-17AEP | UNITED STATES DISTRICT COURT | 2018-05-16 | 2023-06-11 | $409,255.48 | CAMBRIDGE THERAPEUTIC TECHNOLOGIES, LLC, GLENPOINTE CENTER WEST, 500 FRANK W. BURR BLVD., SUITE 4, TEANECK, NJ 07666-6802 |
| J13000877663 | TERMINATED | 1000000500325 | PINELLAS | 2013-04-24 | 2033-05-03 | $ 330.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, CLEARWATER SERVICE CENTER, 19337 US HIGHWAY 19 N STE 200, CLEARWATER FL337643149 |
| Name | Date |
|---|---|
| Reg. Agent Resignation | 2019-11-26 |
| ANNUAL REPORT | 2018-04-19 |
| ANNUAL REPORT | 2017-04-29 |
| ANNUAL REPORT | 2016-04-27 |
| ANNUAL REPORT | 2015-02-23 |
| ANNUAL REPORT | 2014-03-20 |
| Amendment | 2013-05-15 |
| ANNUAL REPORT | 2013-03-26 |
| ANNUAL REPORT | 2012-04-18 |
| ANNUAL REPORT | 2011-03-14 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State
