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  5. BROOKSVILLE DRUGS, INC.

BROOKSVILLE DRUGS, INC.

Company Details

Entity Name: BROOKSVILLE DRUGS, INC.
Jurisdiction: FLORIDA
Filing Type: Domestic Profit
Status: Inactive
Date Filed: 21 Sep 1990 (34 years ago)
Document Number: S02978
FEI/EIN Number 593026478
Mail Address: 5908 Breckenridge Pkwy, Tampa, FL, 33610, US
Address: 80 PONCE DE LEON BLVD, BROOKSVILLE, FL, 34601, US
ZIP code: 34601
County: Hernando
Place of Formation: FLORIDA

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1003991399 2006-10-26 2020-09-02 80 PONCE DE LEON BLVD, BROOKSVILLE, FL, 34601, US 80 PONCE DE LEON BLVD., BROOKSVILLE, FL, 34601, US

Contacts
Phone +1 352-796-4975
Fax 3527338307
Fax 3527998307

Authorized person
Name ALPESH PATEL
Role OWNER
Phone 8133042221

Taxonomy
Taxonomy Code 163WD0400X - Diabetes Educator Registered Nurse
Is Primary No
Taxonomy Code 333600000X - Pharmacy
Is Primary No
Taxonomy Code 3336C0003X - Community/Retail Pharmacy
License Number PH6749
State FL
Is Primary No
Taxonomy Code 3336C0003X - Community/Retail Pharmacy
License Number FL6749
State FL
Is Primary Yes

Other Provider Identifiers
Issuer MEDICAID
Number 003463800
State FL
Issuer NCPDP PROVIDER IDENTIFICATION NUMBER
Number 1033202

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BROOKSVILLE DRUGS INC. 401K PLAN 2015 593026478 2016-11-03 BROOKSVILLE DRUGS, INC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-06-01
Business code 424210
Sponsor’s telephone number 8133042221
Plan sponsor’s address 80 PONCE DE LEON BLVD, BROOKSVILLE, FL, 34601

Signature of
Role Plan administrator
Date 2016-11-03
Name of individual signing DIANA CALLE
Valid signature Filed with authorized/valid electronic signature
BROOKSVILLE DRUGS INC. 401K PLAN 2015 593026478 2016-11-21 BROOKSVILLE DRUGS, INC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-06-01
Business code 424210
Sponsor’s telephone number 8133042221
Plan sponsor’s address 80 PONCE DE LEON BLVD, BROOKSVILLE, FL, 34601

Signature of
Role Plan administrator
Date 2016-11-21
Name of individual signing DIANA CALLE
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2016-11-21
Name of individual signing DIANA CALLE
Valid signature Filed with authorized/valid electronic signature
BROOKSVILLE DRUGS INC. 401K PLAN 2014 593026478 2016-01-12 BROOKSVILLE DRUGS, INC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-06-01
Business code 424210
Sponsor’s telephone number 8133042221
Plan sponsor’s address 80 PONCE DE LEON BLVD, BROOKSVILLE, FL, 34601

Signature of
Role Plan administrator
Date 2016-01-12
Name of individual signing DIANA CALLE
Valid signature Filed with authorized/valid electronic signature
BROOKSVILLE DRUGS INC. 401K PLAN 2013 593026478 2014-06-18 BROOKSVILLE DRUGS, INC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-06-01
Business code 424210
Sponsor’s telephone number 3527964975
Plan sponsor’s address 80 PONCE DE LEON BLVD, BROOKSVILLE, FL, 34601

Signature of
Role Plan administrator
Date 2014-06-18
Name of individual signing KAUSHAL SHAH
Valid signature Filed with authorized/valid electronic signature
BROOKSVILLE DRUGS INC. 401K PLAN 2012 593026478 2013-07-10 BROOKSVILLE DRUGS, INC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-06-01
Business code 424210
Sponsor’s telephone number 3527964975
Plan sponsor’s address 80 PONCE DE LEON BLVD, BROOKSVILLE, FL, 34601

Signature of
Role Plan administrator
Date 2013-07-10
Name of individual signing CALLISTA TOLBERT
Valid signature Filed with authorized/valid electronic signature
BROOKSVILLE DRUGS INC. 401K PLAN 2011 593026478 2012-07-18 BROOKSVILLE DRUGS, INC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-06-01
Business code 424210
Sponsor’s telephone number 3527964973
Plan sponsor’s address 80 PONCE DE LEON BLVD, BROOKSVILLE, FL, 34601

Plan administrator’s name and address
Administrator’s EIN 593026478
Plan administrator’s name BROOKSVILLE DRUGS, INC
Plan administrator’s address 80 PONCE DE LEON BLVD, BROOKSVILLE, FL, 34601
Administrator’s telephone number 3527964973

Signature of
Role Plan administrator
Date 2012-07-18
Name of individual signing CALLISTA TOLBERT
Valid signature Filed with authorized/valid electronic signature
BROOKSVILLE DRUGS INC. 401K PLAN 2010 593026478 2011-07-20 BROOKSVILLE DRUGS, INC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2003-06-01
Business code 424210
Sponsor’s telephone number 3527964975
Plan sponsor’s address 80 PONCE DE LEON BLVD, BROOKSVILLE, FL, 34601

Plan administrator’s name and address
Administrator’s EIN 593026478
Plan administrator’s name BROOKSVILLE DRUGS, INC
Plan administrator’s address 80 PONCE DE LEON BLVD, BROOKSVILLE, FL, 34601
Administrator’s telephone number 3527964975

Signature of
Role Plan administrator
Date 2011-07-20
Name of individual signing CALLISTA TOLBERT
Valid signature Filed with authorized/valid electronic signature

Agent

Name Role Address
PATEL ALPESH M Agent 5908 Breckenridge Pkwy, Tampa, FL, 33610

President

Name Role Address
PETEL MANISH President 5908 BRECKENRIDGE PKWY, TAMPA, FL, 33610

Secretary

Name Role Address
PETEL MANISH Secretary 5908 BRECKENRIDGE PKWY, TAMPA, FL, 33610

Vice President

Name Role Address
PATEL ALPESH Vice President 5908 BRECKENRIDGE PKWY, TAMPA, FL, 33610

Treasurer

Name Role Address
PATEL ALPESH Treasurer 5908 BRECKENRIDGE PKWY, TAMPA, FL, 33610

Fictitious Names

Registration Number Fictitious Name Status Filed Date Expiration Date Cancellation Date Mailing Address
G20000066947 BROOKSVILLE DRUGS ACTIVE 2020-06-15 2025-12-31 No data 5908 BRECKENRIDGE PARKWAY, TAMPA, FL, 33610

Events

Event Type Filed Date Value Description
ADMIN DISSOLUTION FOR ANNUAL REPORT 2024-09-27 No data No data
NAME CHANGE AMENDMENT 2020-07-31 BROOKSVILLE DRUGS, INC. No data
NAME CHANGE AMENDMENT 2018-10-01 BENZER FL 39, INC. No data
AMENDMENT 2017-11-03 No data No data

Related by officers

PATEL ALPESH

WELLCARE PHARMACY SERVICES, INC. TVPHARMACIST L.L.C. PRONTO-MED INC RX ONE PHARMACY, LLC API'S SWEETS LLC NATEL NEUTRATEC USA LLC SAVE AT MOBILE LLC JNRC L.L.C RX CARE OF LADY LAKE, INC PATEL BROTHERS OF ORLANDO LLC

PATEL ALPESH M

NATEL NEUTRATEC USA LLC RX CARE 9 LLC BIJOY INVESTMENT LLC BRIGHT DISCOUNT BEVERAGE INC. FRAG SHAK, INC.

Related by address

5908 Breckenridge Pkwy, Tampa, FL, 33610, US

WELLCARE PHARMACY SERVICES, INC. PRONTO-MED INC RX ONE PHARMACY, LLC RAVKOO INC RX CARE OF LADY LAKE, INC RX CARE CONSULTANTS LLC RX CARE FOUR LLC SKY CITY PHARMACY LLC RX CARE 7 LLC RX CARE 10 LLC

Date of last update: 03 Jan 2025

Sources: Florida Department of State

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