| Entity Name: | CONNECTICUT PHARMACY MEDICAL SUPPLY, LLC |
| Jurisdiction: | Connecticut |
| Legal type: | LLC |
| Citizenship: | Domestic |
| Status: | Active |
| Sub status: | Annual report due |
| Date Formed: | 09 Jul 2004 |
| Business ALEI: | 0790295 |
| Annual report due: | 31 Mar 2025 |
| NAICS code: | 456110 - Pharmacies and Drug Retailers |
| Business address: | 6 S Cove Road, Number 1, Old Saybrook, CT, 06475, United States |
| Mailing address: | 6 S Cove Road, Number 1, Old Saybrook, CT, United States, 06475 |
| ZIP code: | 06475 |
| County: | Middlesex |
| Place of Formation: | CONNECTICUT |
| E-Mail: | bryan@ctpharmacy.net |
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | CONNECTICUT PHARMACY MEDICAL SUPPLY, LLC | 4684569 | NEW YORK |
| Plan Name | Plan Year | EIN/PN | Received | Sponsor | Total number of participants | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CONNECTICUT PHARMACY MEDICAL SUPPLY 401K PROFIT SHARING PLAN & TRUST | 2020 | 201255415 | 2021-10-19 | CONNECTICUT PHARMACY MEDICAL SUPPLY | 18 | |||||||||||||||||||||||||||||||||
|
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| Role | Plan administrator |
| Date | 2021-10-19 |
| Name of individual signing | KIMBERLY CAPPUCCI |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2021-10-19 |
| Name of individual signing | KIMBERLY CAPPUCCI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2016-01-01 |
| Business code | 446110 |
| Sponsor’s telephone number | 2037471155 |
| Plan sponsor’s address | 11 BISHOP RD, OXFORD, CT, 064781597 |
Signature of
| Role | Plan administrator |
| Date | 2021-03-09 |
| Name of individual signing | KIMBERLY CAPPUCCI |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2021-03-09 |
| Name of individual signing | KIMBERLY CAPPUCCI |
| Valid signature | Filed with authorized/valid electronic signature |
| File | View Page |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2016-01-01 |
| Business code | 446110 |
| Sponsor’s telephone number | 2037471155 |
| Plan sponsor’s address | 11 BISHOP RD, OXFORD, CT, 064781597 |
Signature of
| Role | Plan administrator |
| Date | 2021-10-14 |
| Name of individual signing | KIMBERLY CAPPUCCI |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2021-10-14 |
| Name of individual signing | KIMBERLY CAPPUCCI |
| Valid signature | Filed with authorized/valid electronic signature |
| Three-digit plan number (PN) | 001 |
| Effective date of plan | 2016-01-01 |
| Business code | 446110 |
| Sponsor’s telephone number | 2037471155 |
| Plan sponsor’s address | 11 BISHOP RD, OXFORD, CT, 064781597 |
Signature of
| Role | Plan administrator |
| Date | 2021-03-09 |
| Name of individual signing | KIMBERLY CAPPUCCI |
| Valid signature | Filed with authorized/valid electronic signature |
| Role | Employer/plan sponsor |
| Date | 2021-03-09 |
| Name of individual signing | KIMBERLY CAPPUCCI |
| Valid signature | Filed with authorized/valid electronic signature |
| Name | Role | Business address | Phone | Residence address | |
|---|---|---|---|---|---|
| KRISTIN LENTINI | Officer | 664 MAIN AVE, UNIT B102, NORWALK, CT, 06851, United States | No data | No data | 571 COOK HILL ROAD, CHESHIRE, CT, 06410, United States |
| SCOTT WOLAK | Officer | 664 Main Ave, Unit B102, Norwalk, CT, 06851, United States | +1 203-518-1146 | swolak@comcast.net | 6 S Cove Rd, Number 1, Old Saybrook, CT, 06475-2922, United States |
| Name | Role | Business address | Mailing address | Phone | Residence address | |
|---|---|---|---|---|---|---|
| SCOTT WOLAK | Agent | 6 S Cove Rd, Number 1, Old Saybrook, CT, 06475-2922, United States | 6 S Cove Rd, Number 1, Old Saybrook, CT, 06475-2922, United States | +1 203-518-1146 | swolak@comcast.net | 6 S Cove Rd, Number 1, Old Saybrook, CT, 06475-2922, United States |
| Credential | Credential type | Status | Status reason | Issue date | Effective date | Expiration date |
|---|---|---|---|---|---|---|
| PCY.0000434 | PHARMACY | INACTIVE | No data | 2004-09-01 | 2019-01-17 | 2020-08-31 |
| Type | Old value | New value | Date of change |
|---|---|---|---|
| Name change | THE MEDICINE CENTRE/HOPE STREET, LLC | CONNECTICUT PHARMACY MEDICAL SUPPLY, LLC | 2013-11-15 |
| Name change | ASSURED VEHICLE RECOVERY, LLC | THE MEDICINE CENTRE/HOPE STREET, LLC | 2005-04-11 |
| Filing number | Filing date | Effective date | Filing category | Filing type | Report year |
|---|---|---|---|---|---|
| BF-0012318359 | 2024-01-05 | No data | Annual Report | Annual Report | No data |
| BF-0011278607 | 2023-02-09 | No data | Annual Report | Annual Report | No data |
| BF-0010272853 | 2022-02-27 | No data | Annual Report | Annual Report | 2022 |
| 0007185719 | 2021-02-23 | No data | Annual Report | Annual Report | 2021 |
| 0006855588 | 2020-03-30 | No data | Annual Report | Annual Report | 2020 |
| 0006440456 | 2019-03-11 | No data | Annual Report | Annual Report | 2019 |
| 0006015719 | 2018-01-18 | No data | Annual Report | Annual Report | 2018 |
| 0005870256 | 2017-06-19 | No data | Annual Report | Annual Report | 2017 |
| 0005607030 | 2016-07-21 | No data | Annual Report | Annual Report | 2016 |
| 0005607023 | 2016-07-21 | No data | Annual Report | Annual Report | 2015 |
Date of last update: 25 Nov 2024
Sources: Connecticut's Official State Website
