| Entity Name: | LINTON SQUARE PHARMACY & MEDICAL SUPPLIES, INC. |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Active |
| Date Filed: | 19 Oct 1998 (26 years ago) |
| Last Event: | REINSTATEMENT |
| Event Date Filed: | 04 Mar 2002 (23 years ago) |
| Document Number: | P98000088967 |
| FEI/EIN Number | 650869982 |
| Address: | 1601 S. CONGRESS AVE., DELRAY BEACH, FL, 33445, US |
| Mail Address: | 1601 S. CONGRESS AVE., DELRAY BEACH, FL, 33445, US |
| ZIP code: | 33445 |
| County: | Palm Beach |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1609845502 | 2006-03-15 | 2024-02-22 | 1601 S CONGRESS AVE, DELRAY BEACH, FL, 334456368, US | 1601 S CONGRESS AVE, DELRAY BEACH, FL, 334456368, US | |||||||||||||||||||||||||||||||||||||||||||
|
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| Phone | +1 561-272-0015 |
| Fax | 5612723059 |
Authorized person
| Name | DANIEL BEN-AMOZ |
| Role | BENEFICIAL OWNER |
| Phone | 5612720015 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | PH24229 |
| State | FL |
| Is Primary | Yes |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 106586600 |
| State | FL |
| Issuer | MEDICAID |
| Number | 106586601 |
| State | FL |
| Issuer | PK |
| Number | 2012143 |
| Name | Role |
|---|---|
| CORPORATE CREATIONS NETWORK INC. | Agent |
| Name | Role | Address |
|---|---|---|
| Ben-Amoz Daniel | President | 1601 S. CONGRESS AVE., DELRAY BEACH, FL, 33445 |
| Name | Role | Address |
|---|---|---|
| Ben-Amoz Daniel | Director | 1601 S. CONGRESS AVE., DELRAY BEACH, FL, 33445 |
| Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
|---|---|---|---|---|---|---|
| G24000025880 | RXVIP | ACTIVE | 2024-02-16 | 2029-12-31 | No data | 1601 S. CONGRESS AVE., DELRAY BEACH, FL, 33445 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| REGISTERED AGENT NAME CHANGED | 2024-12-19 | CORPORATE CREATIONS NETWORK INC | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2024-12-19 | 801 US HWY 1, NORTH PALM BEACH, FL 33408 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2015-04-07 | 1601 S. CONGRESS AVE., DELRAY BEACH, FL 33445 | No data |
| CHANGE OF MAILING ADDRESS | 2015-04-07 | 1601 S. CONGRESS AVE., DELRAY BEACH, FL 33445 | No data |
| REINSTATEMENT | 2002-03-04 | No data | No data |
| ADMIN DISSOLUTION FOR ANNUAL REPORT | 2000-09-22 | No data | No data |
| Name | Date |
|---|---|
| Reg. Agent Change | 2024-12-19 |
| ANNUAL REPORT | 2024-02-16 |
| ANNUAL REPORT | 2023-03-03 |
| ANNUAL REPORT | 2022-03-08 |
| ANNUAL REPORT | 2021-01-17 |
| ANNUAL REPORT | 2020-05-12 |
| ANNUAL REPORT | 2019-02-17 |
| ANNUAL REPORT | 2018-03-05 |
| ANNUAL REPORT | 2017-02-19 |
| ANNUAL REPORT | 2016-04-11 |
Date of last update: 02 Feb 2025
Sources: Florida Department of State
