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  5. JACK'S PHARMACY INCORPORATED

JACK'S PHARMACY INCORPORATED

Company Details

Name: JACK'S PHARMACY INCORPORATED
Jurisdiction: Idaho
Legal type: General Business Corporation (D)
Status: Active-Good Standing
Date of registration: 13 Feb 1979 (46 years ago)
Financial Date End: 28 Feb 2025
Entity Number: 192541
Place of Formation: IDAHO
File Number: 192541
ZIP code: 83861
County: Benewah County
Mailing Address: 103 E COLLEGE AVE ST MARIES, ID 83861-2247

Unique Entity ID

Unique Entity ID Expiration Date Physical Address Mailing Address
LVPMWJFZG9K3 2022-01-27 103 E COLLEGE AVE, SAINT MARIES, ID, 83861, 2247, USA 103 E COLLEGE AVE, SAINT MARIES, ID, 83861, 2247, USA

Business Information
Doing Business As GOOD NEIGHBOR PHARMACY
Congressional District 01
State/Country of Incorporation ID, USA
Activation Date 2021-02-03
Initial Registration Date 2020-02-07
Entity Start Date 1979-02-13
Fiscal Year End Close Date Sep 30

Points of Contacts
Electronic Business
Title PRIMARY POC
Name SALLY DARLEY
Role PRESIDENT
Address 103 E COLLEGE AVE, ST MARIES, ID, 83861, USA
Government Business
Title PRIMARY POC
Name SALLY DARLEY
Role PRESIDENT
Address 103 E COLLEGE AVE, ST MARIES, ID, 83861, USA
Past Performance Information not Available

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
JACK'S PHARMACY 401(K) PLAN 2020 820347008 2021-05-11 JACK'S PHARMACY INCORPORATED 7
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-10-01
Business code 446110
Sponsor’s telephone number 2082454578
Plan sponsor’s address 103 E. COLLEGE AVE., ST. MARIES, ID, 83861

Signature of
Role Plan administrator
Date 2021-05-11
Name of individual signing SALLY DARLEY
Valid signature Filed with authorized/valid electronic signature
JACK'S PHARMACY 401(K) PLAN 2019 820347008 2021-01-20 JACK'S PHARMACY INCORPORATED 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-10-01
Business code 446110
Sponsor’s telephone number 2082454578
Plan sponsor’s address 103 E. COLLEGE AVE., ST. MARIES, ID, 83861

Signature of
Role Plan administrator
Date 2021-01-20
Name of individual signing SALLY DARLEY
Valid signature Filed with authorized/valid electronic signature
JACK'S PHARMACY 401(K) PLAN 2018 820347008 2020-01-30 JACK'S PHARMACY INCORPORATED 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-10-01
Business code 446110
Sponsor’s telephone number 2082454578
Plan sponsor’s address 103 E. COLLEGE AVE., ST. MARIES, ID, 83861

Signature of
Role Plan administrator
Date 2020-01-30
Name of individual signing COLT DARLEY
Valid signature Filed with authorized/valid electronic signature
JACK'S PHARMACY 401(K) PLAN 2017 820347008 2018-11-14 JACK'S PHARMACY INCORPORATED 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-10-01
Business code 446110
Sponsor’s telephone number 2082454578
Plan sponsor’s address 103 E. COLLEGE AVE., ST. MARIES, ID, 83861

Signature of
Role Plan administrator
Date 2018-11-14
Name of individual signing CHAD BROWN
Valid signature Filed with authorized/valid electronic signature
JACK'S PHARMACY 401(K) PLAN 2013 820347008 2014-12-17 JACK'S PHARMACY INCORPORATED 12
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2009-10-01
Business code 446110
Sponsor’s telephone number 2082454578
Plan sponsor’s address 103 E. COLLEGE AVE., ST. MARIES, ID, 83861

Plan administrator’s name and address
Administrator’s EIN 820347008
Plan administrator’s name JACK'S PHARMACY INCORPORATED
Plan administrator’s address 103 E. COLLEGE AVE., ST. MARIES, ID, 83861
Administrator’s telephone number 2082454578

Signature of
Role Plan administrator
Date 2014-12-17
Name of individual signing CHAD BROWN
Valid signature Filed with authorized/valid electronic signature
Role Employer/plan sponsor
Date 2014-12-17
Name of individual signing CHAD BROWN
Valid signature Filed with authorized/valid electronic signature

President

Name Role Address Appointed On
Sally L Darley President 13403 NORTH GOVERNMENT WAY, HAYDEN, ID 83835 2021-02-17
Sally L Payne President 13403 NORTH GOVERNMENT WAY, HAYDEN, ID 83835 2024-02-20

Director

Name Role Address Appointed On
Benjamin R Potter Director 13403 NORTH GOVERNMENT WAY, HAYDEN, ID 83835 2024-02-20

Agent

Name Role Address
PotterBulwark Inc. Agent 13403 NORTH GOVERNMENT WAY, 217, HAYDEN, ID 83835

Filing

Filing Name Filing Number Filing date
Annual Report 0005608229 2024-02-20
Annual Report 0005124517 2023-02-24
Annual Report 0004551061 2022-01-03
Annual Report 0004176487 2021-02-17
Annual Report 0003729586 2020-01-04
Articles of Amendment 0003694201 2019-12-02
Change of Registered Office/Agent/Both (by Entity) 0003694172 2019-12-02
Annual Report 0003423337 2019-02-05
Annual Report 0001686655 2018-01-09
Annual Report 0001686654 2016-12-22

Related by officers

Benjamin R Potter

PotterBulwark Inc.

PotterBulwark Inc.

North Idaho Plumbing Service, Inc

Related by address

No related companies by address

Date of last update: 17 Jan 2025

Sources: Idaho Secretary of State

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