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Gentry Pharmacy, LLC

Details

Name: Gentry Pharmacy, LLC
Jurisdiction: Alabama
Legal type: Domestic Limited Liability Company
Status: Exists
Date of registration: 27 Jan 2011 (14 years ago) (Companies founded in January 2011)
Entity Number: 000-001-467
Register Number: 000001467
ZIP code: 35243 (Companies in Jefferson, 35243)
County: Jefferson
Place of Formation: Jefferson County
Registered Office Street Address: 2662 DENYSE DRIVEBIRMINGHAM, AL 35243

Activities RETAIL PHARMACY BUSINESS

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1578857108 2011-05-31 2021-08-19 3100 BLUE LAKE DRIVE, VESTAVIA, AL, 35243, US 3100 BLUE LAKE DRIVE, VESTAVIA, AL, 35243, US

Contacts

Phone +1 205-970-1983
Fax 2059701986

Authorized person

Name ROBERT CLINT GENTRY
Role OWNER/MANAGER
Phone 2059701983

Taxonomy

Taxonomy Code 333600000X - Pharmacy
Is Primary No
Taxonomy Code 3336C0003X - Community/Retail Pharmacy
License Number 113729
State AL
Is Primary Yes
Taxonomy Code 3336C0004X - Compounding Pharmacy
Is Primary No

Other Provider Identifiers

Issuer PK
Number 2130074
Issuer MEDICAID
Number 129374
State AL

Organizer

Name Role Address
PRITCHARD, WILLIAM S III Organizer 505 20TH STREET N STE 1210BIRMINGHAM, AL 35203
GENTRY, ROBERT CLINTON Organizer 2662 DENYSE DRIVEBIRMINGHAM, AL 35243

Agent

Name Role
GENTRY, ROBERT C Agent

Date of last update: 29 Jul 2024

Sources: Alabama Secretary of State