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SOUTH PARK PHARMACY, LLC

Company Details

Name: SOUTH PARK PHARMACY, LLC
Jurisdiction: New York
Legal type: DOMESTIC LIMITED LIABILITY COMPANY
Status: Active
Date of registration: 28 Oct 2005 (19 years ago)
Entity Number: 3274286
County: Erie
Place of Formation: New York
Address: NEMASTE, LLC, 6780 PITTSFORD-PALMYRA RD 2A-3, FAIRPORT, NY, United States, 14450
Address ZIP Code: 14450

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
SOUTH PARK PHARMACY 401(K) PLAN 2020 203816744 2021-03-01 SOUTH PARK PHARMACY, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-05-01
Business code 446110
Sponsor’s telephone number 7168230440
Plan sponsor’s address 2707 SOUTH PARK AVENUE, LACKAWANNA, NY, 14218

Signature of
Role Plan administrator
Date 2021-02-27
Name of individual signing SHAWN SHELTON
Role Employer/plan sponsor
Date 2021-02-27
Name of individual signing SHAWN SHELTON
SOUTH PARK PHARMACY 401(K) PLAN 2019 203816744 2020-06-03 SOUTH PARK PHARMACY, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-05-01
Business code 446110
Sponsor’s telephone number 7168230440
Plan sponsor’s address 2707 SOUTH PARK AVENUE, LACKAWANNA, NY, 14218

Signature of
Role Plan administrator
Date 2020-06-03
Name of individual signing SHAWN SHELTON
Role Employer/plan sponsor
Date 2020-06-03
Name of individual signing SHAWN SHELTON
SOUTH PARK PHARMACY 401(K) PLAN 2018 203816744 2019-09-26 SOUTH PARK PHARMACY, LLC 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-05-01
Business code 446110
Sponsor’s telephone number 7168230440
Plan sponsor’s address 2707 SOUTH PARK AVENUE, LACKAWANNA, NY, 14218

Signature of
Role Plan administrator
Date 2019-09-25
Name of individual signing SHAWN SHELTON
Role Employer/plan sponsor
Date 2019-09-25
Name of individual signing SHAWN SHELTON
SOUTH PARK PHARMACY 401(K) PLAN 2017 203816744 2018-09-13 SOUTH PARK PHARMACY, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-05-01
Business code 446110
Sponsor’s telephone number 7168230440
Plan sponsor’s address 2707 SOUTH PARK AVENUE, LACKAWANNA, NY, 14218

Signature of
Role Plan administrator
Date 2018-09-13
Name of individual signing SHAWN SHELTON
Role Employer/plan sponsor
Date 2018-09-13
Name of individual signing SHAWN SHELTON
SOUTH PARK PHARMACY 401(K) PLAN 2016 203816744 2017-07-13 SOUTH PARK PHARMACY, LLC 5
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-05-01
Business code 446110
Sponsor’s telephone number 7168230440
Plan sponsor’s address 2707 SOUTH PARK AVENUE, LACKAWANNA, NY, 14218

Signature of
Role Plan administrator
Date 2017-07-13
Name of individual signing SHAWN SHELTON
Role Employer/plan sponsor
Date 2017-07-13
Name of individual signing SHAWN SHELTON
SOUTH PARK PHARMACY 401(K) PLAN 2015 203816744 2016-07-11 SOUTH PARK PHARMACY, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-05-01
Business code 446110
Sponsor’s telephone number 7168230440
Plan sponsor’s address 2707 SOUTH PARK AVENUE, LACKAWANNA, NY, 14218

Signature of
Role Plan administrator
Date 2016-06-27
Name of individual signing SHAWN SHELTON
Role Employer/plan sponsor
Date 2016-06-27
Name of individual signing SHAWN SHELTON
SOUTH PARK PHARMACY 401(K) PLAN 2014 203816744 2015-10-06 SOUTH PARK PHARMACY, LLC 4
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2014-05-01
Business code 446110
Sponsor’s telephone number 7168230440
Plan sponsor’s address 2707 SOUTH PARK AVENUE, LACKAWANNA, NY, 14218

Signature of
Role Plan administrator
Date 2015-10-06
Name of individual signing SHAWN SHELTON
Role Employer/plan sponsor
Date 2015-10-06
Name of individual signing SHAWN SHELTON

DOS Process Agent

Name Role Address
THE LLC DOS Process Agent NEMASTE, LLC, 6780 PITTSFORD-PALMYRA RD 2A-3, FAIRPORT, NY, United States, 14450

History

Start date End date Type Value
2005-10-28 2007-10-26 Address 5555 MAIN STREET, WILLIAMSVILLE, NY, 14221, USA (Type of address: Service of Process)

Filings

Filing Number Date Filed Type Effective Date
131023002264 2013-10-23 BIENNIAL STATEMENT 2013-10-01
111019002139 2011-10-19 BIENNIAL STATEMENT 2011-10-01
091019002419 2009-10-19 BIENNIAL STATEMENT 2009-10-01
071026002881 2007-10-26 BIENNIAL STATEMENT 2007-10-01
060403000958 2006-04-03 AFFIDAVIT OF PUBLICATION 2006-04-03
060403000955 2006-04-03 AFFIDAVIT OF PUBLICATION 2006-04-03
051028000043 2005-10-28 ARTICLES OF ORGANIZATION 2005-10-28

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Date of last update: 10 Nov 2024

Sources: New York Secretary of State

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