| Entity Name: | PRIME MEDICAL SUPPLIES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Profit Corporation |
| Status: | Inactive |
| Date Filed: | 03 Jan 2011 (14 years ago) |
| Date of dissolution: | 27 Sep 2024 (5 months ago) |
| Last Event: | ADMIN DISSOLUTION FOR ANNUAL REPORT |
| Event Date Filed: | 27 Sep 2024 (5 months ago) |
| Document Number: | P11000000299 |
| FEI/EIN Number | 35-2412595 |
| Address: | 600 N. CONGRESS AVE - STE. 130, DELRAY BEACH, FL 33445 |
| Mail Address: | 600 N. CONGRESS AVE - STE. 130, DELRAY BEACH, FL 33445 |
| ZIP code: | 33445 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1295023059 | 2011-07-14 | 2022-06-06 | 600 N CONGRESS AVE STE 130, DELRAY BEACH, FL, 334453433, US | 600 N CONGRESS AVE STE 130, DELRAY BEACH, FL, 334453433, US | |||||||||||||||||||||||||||||
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| Phone | +1 561-588-0707 |
| Fax | 5615880747 |
Authorized person
| Name | LOUIS SITARAS |
| Role | OWNER |
| Phone | 5615880707 |
Taxonomy
| Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH25600 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 004149501 |
| State | FL |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| PRIME MEDICAL SUPPLIES, INC. 401(K) P/S PLAN | 2022 | 352412595 | 2023-03-27 | PRIME MEDICAL SUPPLIES, INC. | 8 | |||||||||||||||||||||||||||||||
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| Administrator’s EIN | 352412595 |
| Plan administrator’s name | PRIME MEDICAL SUPPLIES, INC. |
| Plan administrator’s address | 600 N CONGRESS AVE STE 130, DELRAY BEACH, FL, 33445 |
| Administrator’s telephone number | 7042243234 |
Signature of
| Role | Plan administrator |
| Date | 2023-03-27 |
| Name of individual signing | ADELE BERCHEM |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Address |
|---|---|---|
| SITARAS, LOUIS | Agent | 5481 OLD MYSTIC DRIVE, JUPITER, FL 33458 |
| Name | Role | Address |
|---|---|---|
| SITARAS, LOUIS | President | 600 N. CONGRESS AVE - STE. 130, DELRAY BEACH, FL 33445 |
| Name | Role | Address |
|---|---|---|
| SITARAS, LOUIS | Director | 600 N. CONGRESS AVE - STE. 130, DELRAY BEACH, FL 33445 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G20000146922 | CONGRESS PHARMACY | ACTIVE | 2020-11-16 | 2025-12-31 | No data | 600 N CONGRESS AVE, SUITE 130, DELRAY BEACH, FL, 33445 |
| G20000022142 | PRIME MEDICAL SUPPLIES | ACTIVE | 2020-02-19 | 2025-12-31 | No data | 400 S DIXIE HIGHWAY, SUITE 17, LAKE WORTH, FL, 33460 |
| G19000126163 | WORKERS COMP MEDS | EXPIRED | 2019-11-26 | 2024-12-31 | No data | 400 S DIXIE HIGHWAY, SUITE 17, LAKE WORTH, FL, 33460 |
| G17000125838 | LAKE WORTH PHARMACY | EXPIRED | 2017-11-15 | 2022-12-31 | No data | 400 SOUTH DIXIE HIGHWAY, SUITE 17, LAKE WORTH, FL, 33460 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2024-09-27 | No data | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2020-10-08 | 600 N. CONGRESS AVE - STE. 130, DELRAY BEACH, FL 33445 | No data |
| CHANGE OF MAILING ADDRESS | 2020-10-08 | 600 N. CONGRESS AVE - STE. 130, DELRAY BEACH, FL 33445 | No data |
| AMENDMENT AND NAME CHANGE | 2020-10-08 | PRIME MEDICAL SUPPLIES, INC. | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2017-11-02 | 5481 OLD MYSTIC DRIVE, JUPITER, FL 33458 | No data |
| AMENDMENT | 2017-11-02 | No data | No data |
| REGISTERED AGENT NAME CHANGED | 2017-11-02 | SITARAS, LOUIS | No data |
| AMENDMENT | 2017-11-01 | No data | No data |
| AMENDMENT | 2014-03-03 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J18000429118 | TERMINATED | 1000000783235 | PALM BEACH | 2018-05-23 | 2038-06-20 | $ 8,890.60 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, WEST PALM BEACH SERVICE CENTER, 2468 METROCENTRE BLVD, WEST PALM BEACH FL334073105 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2023-04-04 |
| ANNUAL REPORT | 2022-04-30 |
| ANNUAL REPORT | 2021-03-16 |
| Amendment and Name Change | 2020-10-08 |
| ANNUAL REPORT | 2020-01-23 |
| ANNUAL REPORT | 2019-01-09 |
| ANNUAL REPORT | 2018-04-16 |
| Amendment | 2017-11-02 |
| Amendment | 2017-11-01 |
| ANNUAL REPORT | 2017-01-25 |
Date of last update: 23 Feb 2025
Sources: Florida Department of State
