Entity Name: | MEMORIAL PILL BOX, INC. |
Jurisdiction: | FLORIDA |
Filing Type: | Florida Profit Corporation |
Status: | Active |
Date Filed: | 19 Aug 1991 (33 years ago) |
Last Event: | AMENDMENT |
Event Date Filed: | 18 Nov 2020 (4 years ago) |
Document Number: | S74097 |
FEI/EIN Number | 65-0290465 |
Mail Address: | 122 W 146th St, New York, NY 10039 |
Address: | 168 NW 26th St, Miami, FL 33127 |
ZIP code: | 33127 |
County: | Miami-Dade |
Place of Formation: | FLORIDA |
NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
1780676510 | 2005-08-18 | 2022-09-06 | 122 W 146TH ST, NEW YORK, NY, 100393802, US | 168 NW 26TH ST, MIAMI, FL, 331274422, US | |||||||||||||||||||||||||||||||||||||||||
|
Phone | +1 888-685-9515 |
Fax | 6469346409 |
Phone | +1 305-515-9000 |
Fax | 9543686833 |
Authorized person
Name | ERIC KINARIWALA |
Role | SOLE MEMBER |
Phone | 8886859515 |
Taxonomy
Taxonomy Code | 332B00000X - Durable Medical Equipment & Medical Supplies |
License Number | PH11940 |
State | FL |
Is Primary | No |
Taxonomy Code | 333600000X - Pharmacy |
License Number | PH11940 |
State | FL |
Is Primary | No |
Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
Is Primary | Yes |
Other Provider Identifiers
Issuer | MEDICAID |
Number | 101616400 |
State | FL |
Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
JOHN KROSS PHARMACY 401(K) PLAN | 2020 | 650290465 | 2021-10-28 | MEMORIAL PILL BOX INC | 9 | |||||||||||||||||||||||
|
Role | Plan administrator |
Date | 2021-10-28 |
Name of individual signing | JOHN KROSS |
Valid signature | Filed with authorized/valid electronic signature |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2017-01-01 |
Business code | 446110 |
Sponsor’s telephone number | 9546373401 |
Plan sponsor’s address | 168 NW 26 ST, MIAMI, FL, 33127 |
Signature of
Role | Plan administrator |
Date | 2021-10-22 |
Name of individual signing | JOHN KROSS |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2017-01-01 |
Business code | 446110 |
Sponsor’s telephone number | 9546373401 |
Plan sponsor’s address | 16618 SHERIDAN ST, PEMBROKE PINES, FL, 33331 |
Signature of
Role | Plan administrator |
Date | 2020-07-14 |
Name of individual signing | JENNIFER VALLE |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2017-01-01 |
Business code | 446110 |
Sponsor’s telephone number | 9544363402 |
Plan sponsor’s address | 9108 GRIFFIN RD, COOPER CITY, FL, 33328 |
Signature of
Role | Plan administrator |
Date | 2019-06-25 |
Name of individual signing | JENNIFER VALLE |
Valid signature | Filed with authorized/valid electronic signature |
File | View Page |
Three-digit plan number (PN) | 001 |
Effective date of plan | 2017-01-01 |
Business code | 424210 |
Sponsor’s telephone number | 9544363402 |
Plan sponsor’s address | 9108 GRIFFIN ROAD, COOPER CITY, FL, 33328 |
Signature of
Role | Plan administrator |
Date | 2018-10-02 |
Name of individual signing | JOHN KROSS |
Valid signature | Filed with authorized/valid electronic signature |
Name | Role |
---|---|
COGENCY GLOBAL INC. | Agent |
Name | Role | Address |
---|---|---|
Kinariwala, Eric | President | 122 W 146th St, NEW YORK, NY 10039 |
Registration Number | Fictitious Name | Status | Filed Date | Expiration Date | Cancellation Date | Mailing Address |
---|---|---|---|---|---|---|
G20000145993 | CAPSULE PHARMACY | ACTIVE | 2020-11-13 | 2025-12-31 | No data | 16618 SHERIDAN STREET, PEMBROKE PINES, FL, 33331-3540 |
G17000014917 | JOHN KROSS PHARMACY | EXPIRED | 2017-02-09 | 2022-12-31 | No data | 601 NORTH FLAMINGO ROAD, SUITE 110, PEMBROKE PINES, FL, 33028 |
Event Type | Filed Date | Value | Description |
---|---|---|---|
CHANGE OF MAILING ADDRESS | 2023-05-03 | 168 NW 26th St, Miami, FL 33127 | No data |
CHANGE OF PRINCIPAL ADDRESS | 2021-04-02 | 168 NW 26th St, Miami, FL 33127 | No data |
AMENDMENT | 2020-11-25 | No data | No data |
REGISTERED AGENT NAME CHANGED | 2020-11-25 | COGENCY GLOBAL INC. | No data |
REGISTERED AGENT ADDRESS CHANGED | 2020-11-25 | 115 N CALHOUN ST #4, TALLAHASSEE, FL 32301 | No data |
Name | Date |
---|---|
ANNUAL REPORT | 2024-04-30 |
ANNUAL REPORT | 2023-05-03 |
ANNUAL REPORT | 2022-04-25 |
AMENDED ANNUAL REPORT | 2021-04-02 |
ANNUAL REPORT | 2021-03-23 |
Amendment | 2020-11-18 |
ANNUAL REPORT | 2020-01-17 |
ANNUAL REPORT | 2019-01-28 |
ANNUAL REPORT | 2018-01-12 |
AMENDED ANNUAL REPORT | 2017-08-02 |
Date of last update: 03 Feb 2025
Sources: Florida Department of State