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Beauregard Drugs, Inc.

Details

Name: Beauregard Drugs, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Exists
Date of registration: 09 Sep 2011 (13 years ago)
Entity Number: 000-024-892
Register Number: 000024892
County: Lee
Place of Formation: Lee County
Registered Office Street Address: 2544 BLACKWOOD COURTAUBURN, AL 36830
Registered Office Street Address ZIP Code: 36830
Principal Address: 2544 BLACKWOOD CTAUBURN, AL 36830
Principal Address ZIP Code: 36830
Authorized Capital: 1,000 @ $1 PV

Activities ANY LAWFUL

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1639424328 2012-07-18 2017-02-20 7667 AL HIGHWAY 51 STE A, OPELIKA, AL, 368042200, US 7667 AL HIGHWAY 51, STE A, OPELIKA, AL, 368042200, US

Contacts
Phone +1 334-364-9993
Fax 3343649997

Authorized person
Name TUCKER SIMMONS
Role PRESIDENT
Phone 3343649993

Taxonomy
Taxonomy Code 333600000X - Pharmacy
Is Primary No
Taxonomy Code 3336C0003X - Community/Retail Pharmacy
License Number 113939
State AL
Is Primary Yes
Taxonomy Code 3336C0004X - Compounding Pharmacy
Is Primary No

Other Provider Identifiers
Issuer PK
Number 2136066
Issuer MEDICAID
Number 139875
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BEAUREGARD DRUGS INC (WELFARE PLAN) 2022 452953659 2023-07-27 BEAUREGARD DRUGS INC 2
File View Page
Three-digit plan number (PN) 951
Effective date of plan 2020-10-01
Business code 446110
Sponsor’s telephone number 8669665457
Plan sponsor’s address 7667 AL HIGHWAY 51 SUITE A, OPELIKA, AL, 36804

Plan administrator’s name and address
Administrator’s EIN 472506773
Plan administrator’s name KENNION & CO, LLC
Plan administrator’s address 2828 OLD 280 COURT, SUITE 110, VESTAVIA, AL, 35243
Administrator’s telephone number 8669665457

Signature of
Role Plan administrator
Date 2023-07-18
Name of individual signing W. HAL SHEPHERD
Role Employer/plan sponsor
Date 2023-07-18
Name of individual signing W. HAL SHEPHERD
BEAUREGARD DRUGS INC (WELFARE PLAN) 2021 452953659 2022-07-29 BEAUREGARD DRUGS INC 2
File View Page
Three-digit plan number (PN) 951
Effective date of plan 2020-10-01
Business code 446110
Sponsor’s telephone number 8669665457
Plan sponsor’s address 7667 AL HIGHWAY 51 SUITE A, OPELIKA, AL, 36804

Plan administrator’s name and address
Administrator’s EIN 472506773
Plan administrator’s name KENNION & CO, LLC
Plan administrator’s address 2828 OLD 280 COURT, SUITE 110, VESTAVIA, AL, 35243
Administrator’s telephone number 8669665457

Signature of
Role Plan administrator
Date 2022-07-20
Name of individual signing W. HAL SHEPHERD
Role Employer/plan sponsor
Date 2022-07-20
Name of individual signing W. HAL SHEPHERD
BEAUREGARD DRUGS INC (WELFARE PLAN) 2020 452953659 2021-07-25 BEAUREGARD DRUGS INC 0
File View Page
Three-digit plan number (PN) 951
Effective date of plan 2020-10-01
Business code 446110
Sponsor’s telephone number 8669665457
Plan sponsor’s address 7667 AL HIGHWAY 51 SUITE A, OPELIKA, AL, 36804

Plan administrator’s name and address
Administrator’s EIN 472506773
Plan administrator’s name KENNION & CO, LLC
Plan administrator’s address 2828 OLD 280 COURT, SUITE 110, VESTAVIA, AL, 35243
Administrator’s telephone number 8669665457

Signature of
Role Plan administrator
Date 2021-07-23
Name of individual signing W. HAL SHEPHERD
Role Employer/plan sponsor
Date 2021-07-23
Name of individual signing W. HAL SHEPHERD

Agent

Name Role Address
SIMMONS, TIFFANY Agent 7667 AL HIGHWAY 51 SUITE AOPELIKA, AL 36804

Director

Name Role Address
SIMMONS, TIFFANY F Director 2544 BLACKWOOD COURTAUBURN, AL 36830
SIMMONS, TUCKER D Director 7667 AL HIGHWAY 51 SUITE AOPELIKA, AL 36804

Incorporator

Name Role Address
SIMMONS, TUCKER D Incorporator 7667 AL HIGHWAY 51 SUITE AOPELIKA, AL 36804
SIMMONS, TIFFANY Incorporator 7667 AL HIGHWAY 51 SUITE AOPELIKA, AL 36804

Related by officers

SIMMONS, TIFFANY

Simmons Condominium Owners Association, Inc.

SIMMONS, TIFFANY F

HRW Simmons, LLC

SIMMONS, TUCKER D

HRW Simmons, LLC Simmons Condominium Owners Association, Inc.

Related by address

2544 BLACKWOOD COURTAUBURN, AL 36830

HRW Simmons, LLC

Date of last update: 30 Jul 2024

Sources: Alabama Secretary of State

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