| Name: | Three Notch Pharmacy, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 27 Dec 2011 (13 years ago) (Companies founded in December 2011) |
| Entity Number: | 000-035-051 |
| Register Number: | 000035051 |
| ZIP code: | 36619 (Companies in Mobile, 36619) |
| County: | Mobile |
| Place of Formation: | Escambia County |
| Principal Address: | 4880 LAKELAND DRIVE STE FMOBILE, AL 36619 |
| Registered Office Street Address: | 1121 BELLEVILLE AVENUEBREWTON, AL 36426 |
Activities
RETAIL BUSINESS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1881963460 | 2011-12-28 | 2017-03-17 | 4880 LAKELAND DR, SUITE F, MOBILE, AL, 366191104, US | 4880 LAKELAND DR STE F, MOBILE, AL, 366191122, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 251-661-0066 |
| Fax | 2516610063 |
Authorized person
| Name | CHARLES COTTRELL |
| Role | OWNER/PHARMACIST |
| Phone | 2518020387 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 113860 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 135510 |
| State | AL |
| Issuer | PK |
| Number | 2133675 |
| Name | Role | Address |
|---|---|---|
| COTTRELL, CHARLES D | Agent | 810 EAST CRAIG STREETATMORE, AL 36502 |
| Name | Role | Address |
|---|---|---|
| COTTRELL, CHARLES D | Organizer | 810 EAST CRAIG STREETATMORE, AL 36502 |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
