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  5. CRYSTAL CITY APOTHECARY, LLC

CRYSTAL CITY APOTHECARY, LLC

Company Details

Name: CRYSTAL CITY APOTHECARY, LLC
Jurisdiction: New York
Legal type: DOMESTIC LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 23 Nov 2004 (20 years ago)
Entity Number: 3129422
ZIP code: 14892
County: Steuben
Place of Formation: New York
Address: 443 CAYUTA AVE, WAVERLY, NY, United States, 14892

Contact Details

Phone +1 607-565-2390

Commercial and government entity program

CAGE number Status Type Established CAGE Update Date CAGE Expiration SAM Expiration
7G5H7 Obsolete Non-Manufacturer 2015-09-15 2024-03-10 2022-06-30 No data

Contact Information
POC DONALD W. SASSMAN
Phone +1 607-565-2390
Fax +1 607-565-2393
Address 443 CAYUTA AVE, WAVERLY, NY, 14892 1506, UNITED STATES

Ownership of Offeror Information
Highest Level Owner Information not Available
Immediate Level Owner Information not Available
List of Offerors (0) Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
WAVERLY PHARMACY 401(K) PLAN 2023 134290223 2024-08-27 CRYSTAL CITY APOTHECARY LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-05-01
Business code 424210
Sponsor’s telephone number 6075652390
Plan sponsor’s address 443 CAYUTA AVENUE, WAVERLY, NY, 14892

Signature of
Role Plan administrator
Date 2024-08-27
Name of individual signing DON SASSMAN
WAVERLY PHARMACY 401(K) PLAN 2022 134290223 2023-10-02 CRYSTAL CITY APOTHECARY LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-05-01
Business code 424210
Sponsor’s telephone number 6075652390
Plan sponsor’s address 443 CAYUTA AVENUE, WAVERLY, NY, 14892

Signature of
Role Plan administrator
Date 2023-10-02
Name of individual signing DON SASSMAN
WAVERLY PHARMACY 401(K) PLAN 2021 134290223 2022-10-07 CRYSTAL CITY APOTHECARY LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-05-01
Business code 424210
Sponsor’s telephone number 6075652390
Plan sponsor’s address 443 CAYUTA AVENUE, WAVERLY, NY, 14892
WAVERLY PHARMACY 401(K) PLAN 2020 134290223 2021-09-30 CRYSTAL CITY APOTHECARY LLC 6
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-05-01
Business code 424210
Sponsor’s telephone number 6075652390
Plan sponsor’s address 443 CAYUTA AVENUE, WAVERLY, NY, 14892
WAVERLY PHARMACY 401(K) PLAN 2019 134290223 2020-10-12 CRYSTAL CITY APOTHECARY LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-05-01
Business code 424210
Sponsor’s telephone number 6075652390
Plan sponsor’s address 443 CAYUTA AVENUE, WAVERLY, NY, 14892
WAVERLY PHARMACY 401(K) PLAN 2018 134290223 2019-07-31 CRYSTAL CITY APOTHECARY LLC 9
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-05-01
Business code 424210
Sponsor’s telephone number 6075652390
Plan sponsor’s address 443 CAYUTA AVENUE, WAVERLY, NY, 14892
WAVERLY PHARMACY 401(K) PLAN 2017 134290223 2018-07-27 CRYSTAL CITY APOTHECARY LLC 8
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-05-01
Business code 424210
Sponsor’s telephone number 6075652390
Plan sponsor’s address 443 CAYUTA AVENUE, WAVERLY, NY, 14892
WAVERLY PHARMACY 401(K) PLAN 2016 134290223 2017-07-28 CRYSTAL CITY APOTHECARY LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-05-01
Business code 424210
Sponsor’s telephone number 6075652390
Plan sponsor’s address 443 CAYUTA AVENUE, WAVERLY, NY, 14892

Signature of
Role Plan administrator
Date 2017-07-28
Name of individual signing LARRY RUDAWSKY
WAVERLY PHARMACY 401(K) PLAN 2015 134290223 2016-07-29 CRYSTAL CITY APOTHECARY LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2011-05-01
Business code 424210
Sponsor’s telephone number 6075652390
Plan sponsor’s address 443 CAYUTA AVENUE, WAVERLY, NY, 14892

Signature of
Role Plan administrator
Date 2016-07-29
Name of individual signing DONALD SASSMAN
Role Employer/plan sponsor
Date 2016-07-29
Name of individual signing DONALD SASSMAN

DOS Process Agent

Name Role Address
CRYSTAL CITY APOTHECARY, LLC DOS Process Agent 443 CAYUTA AVE, WAVERLY, NY, United States, 14892

History

Start date End date Type Value
2012-11-07 2018-12-24 Address 443 CAYUTA AVE, WAVERLY, NY, 14892, USA (Type of address: Service of Process)
2008-08-27 2012-11-07 Address 316 BROAD ST, WAVERLY, NY, 14892, USA (Type of address: Service of Process)
2005-02-10 2008-08-27 Address P.O. BOX 1345, CORNING, NY, 14830, USA (Type of address: Service of Process)
2004-11-23 2005-02-10 Address 63-65 MARKET ST, CORNING, NY, 14830, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
221101003117 2022-11-01 BIENNIAL STATEMENT 2022-11-01
201102060825 2020-11-02 BIENNIAL STATEMENT 2020-11-01
181224002020 2018-12-24 BIENNIAL STATEMENT 2018-11-01
181011006159 2018-10-11 BIENNIAL STATEMENT 2016-11-01
141103007435 2014-11-03 BIENNIAL STATEMENT 2014-11-01
121107006193 2012-11-07 BIENNIAL STATEMENT 2012-11-01
101202002360 2010-12-02 BIENNIAL STATEMENT 2010-11-01
080827002717 2008-08-27 BIENNIAL STATEMENT 2008-11-01
050325000088 2005-03-25 AFFIDAVIT OF PUBLICATION 2005-03-25
050325000085 2005-03-25 AFFIDAVIT OF PUBLICATION 2005-03-25

Related by officers

No related officers

Related by address

443 CAYUTA AVE, WAVERLY, NY, United States, 14892

CAYUTA DISTRIBUTORS, LLC WAVERLY PHARMACY HOLDINGS, LLC

Date of last update: 10 Nov 2024

Sources: New York Secretary of State

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