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  5. LIFELINE MEDICAL, INC.

LIFELINE MEDICAL, INC.

Company Details

Entity Name: LIFELINE MEDICAL, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Active
Date Filed: 02 Jan 2015 (10 years ago)
Document Number: P15000001057
FEI/EIN Number 22-3092585
Address: 3703 Lake Center Drive, Mount Dora, FL, 32757, US
Mail Address: 3703 Lake Center Drive, Mount Dora, FL, 32757, US
ZIP code: 32757
County: Lake
Place of Formation: FLORIDA

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
LIFELINE MEDICAL INC 401(K) PROFIT SHARING PLAN & TRUST 2023 223092585 2024-05-29 LIFELINE MEDICAL, INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 423800
Sponsor’s telephone number 2037483806
Plan sponsor’s address 3703 LAKE CENTER DRIVE, MOUNT DORA, FL, 32757

Signature of
Role Plan administrator
Date 2024-05-29
Name of individual signing TUSHAR SHAH
Valid signature Filed with authorized/valid electronic signature
LIFELINE MEDICAL INC 401(K) PROFIT SHARING PLAN & TRUST 2022 223092585 2023-07-25 LIFELINE MEDICAL INC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 423800
Sponsor’s telephone number 2037483806
Plan sponsor’s address 15241 TELECOM DR, BROOKSVILLE, FL, 34604

Signature of
Role Plan administrator
Date 2023-07-25
Name of individual signing TUSHAR SHAH
Valid signature Filed with authorized/valid electronic signature
LIFELINE MEDICAL INC 401(K) PROFIT SHARING PLAN & TRUST 2021 223092585 2022-05-19 LIFELINE MEDICAL INC 17
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 423800
Sponsor’s telephone number 2037483806
Plan sponsor’s address 15241 TELECOM DR, BROOKSVILLE, FL, 34604

Signature of
Role Plan administrator
Date 2022-05-19
Name of individual signing TUSHAR SHAH
Valid signature Filed with authorized/valid electronic signature
LIFELINE MEDICAL INC 401(K) PROFIT SHARING PLAN & TRUST 2020 223092585 2021-04-05 LIFELINE MEDICAL INC 19
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 423800
Sponsor’s telephone number 2037483806
Plan sponsor’s address 15241 TELECOM DR, BROOKSVILLE, FL, 34604

Signature of
Role Plan administrator
Date 2021-04-05
Name of individual signing TUSHAR SHAH
Valid signature Filed with authorized/valid electronic signature
LIFELINE MEDICAL INC 401(K) PROFIT SHARING PLAN & TRUST 2019 223092585 2020-04-28 LIFELINE MEDICAL INC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 423800
Sponsor’s telephone number 2037483806
Plan sponsor’s address 15241 TELECOM DR, BROOKSVILLE, FL, 34604

Signature of
Role Plan administrator
Date 2020-04-28
Name of individual signing TUSHAR SHAH
Valid signature Filed with authorized/valid electronic signature
LIFELINE MEDICAL INC 401 K PROFIT SHARING PLAN TRUST 2018 223092585 2019-03-12 LIFELINE MEDICAL INC 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 423800
Sponsor’s telephone number 2037483806
Plan sponsor’s address 15241 TELECOM DR, BROOKSVILLE, FL, 34604

Signature of
Role Plan administrator
Date 2019-03-12
Name of individual signing TUSHAR SHAH
Valid signature Filed with authorized/valid electronic signature
LIFELINE MEDICAL INC 401 K PROFIT SHARING PLAN TRUST 2017 223092585 2018-04-26 LIFELINE MEDICAL INC 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 423800
Sponsor’s telephone number 2037483806
Plan sponsor’s address 15241 TELECOM DR, BROOKSVILLE, FL, 34604

Signature of
Role Plan administrator
Date 2018-04-26
Name of individual signing TUSHAR SHAH
Valid signature Filed with authorized/valid electronic signature
LIFELINE MEDICAL, INC. 401 K PROFIT SHARING PLAN TRUST 2016 223092585 2017-05-19 LIFELINE MEDICAL, INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 423800
Sponsor’s telephone number 2037483806
Plan sponsor’s address 15241 TELCOM DRIVE, BROOKSVILLE, FL, 34604

Signature of
Role Plan administrator
Date 2017-05-19
Name of individual signing TUSHAR SHAH
Valid signature Filed with authorized/valid electronic signature
LIFELINE MEDICAL, INC. 401 K PROFIT SHARING PLAN TRUST 2015 223092585 2016-05-16 LIFELINE MEDICAL INC. 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 423800
Sponsor’s telephone number 2037483806
Plan sponsor’s address 15241 TELCOM DRIVE, BROOKSVILLE, FL, 34604

Signature of
Role Plan administrator
Date 2016-05-16
Name of individual signing TUSHAR SHAH
Valid signature Filed with authorized/valid electronic signature
LIFELINE MEDICAL INC 401 K PROFIT SHARING PLAN TRUST 2014 223092585 2015-06-11 LIFELINE MEDICAL INC 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2012-01-01
Business code 423800
Sponsor’s telephone number 2037483806
Plan sponsor’s address 15241 TELECOM DR, BROOKSVILLE, FL, 34604

Signature of
Role Plan administrator
Date 2015-06-11
Name of individual signing TUSHAR SHAH
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
SHAH TUSHAR J Agent 3703 Lake Center Drive, Mount Dora, FL, 32757

Director

Name Role Address
SHAH TUSHAR J Director 3703 Lake Center Drive, Mount Dora, FL, 32757

Events

Event Type Filed Date Value Description
CHANGE OF PRINCIPAL ADDRESS 2023-12-06 3703 Lake Center Drive, Mount Dora, FL 32757 No data
CHANGE OF MAILING ADDRESS 2023-12-06 3703 Lake Center Drive, Mount Dora, FL 32757 No data
REGISTERED AGENT ADDRESS CHANGED 2023-12-06 3703 Lake Center Drive, Mount Dora, FL 32757 No data

Documents

Name Date
ANNUAL REPORT 2024-02-05
AMENDED ANNUAL REPORT 2023-12-06
ANNUAL REPORT 2023-02-01
ANNUAL REPORT 2022-02-08
ANNUAL REPORT 2021-01-27
ANNUAL REPORT 2020-01-16
ANNUAL REPORT 2019-02-08
ANNUAL REPORT 2018-01-23
ANNUAL REPORT 2017-01-11
ANNUAL REPORT 2016-03-16

Related by officers

SHAH TUSHAR J

LIFELINE MEDICAL, INC. STELZ, INC. MODUL USA II, INC. PC HOSPITALITY PARTNERS LLC SHRI AMBA MATAJI, INC. PARAS NATH, INC.

Related by address

No related companies by address

Date of last update: 02 Feb 2025

Sources: Florida Department of State

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