| Name: | TRIAD RX, INC. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Corporation |
| Status: | Exists |
| Date of registration: | 09 Jan 2012 (13 years ago) (Companies founded in January 2012) |
| Entity Number: | 000-036-902 |
| Register Number: | 000036902 |
| ZIP code: | 36104 (Companies in Montgomery, 36104) |
| County: | Montgomery |
| Place of Formation: | Baldwin County |
| Registered Office Street Address: | 641 SOUTH LAWRENCE STREETMONTGOMERY, AL 36104 |
| Authorized Capital: | 1,OOO @ $1.00PV |
Activities
PHARMACY
| Type | Company Name | Company Number | State |
|---|---|---|---|
| Headquarter of | TRIAD RX, INC. | 10284725 | Alaska |
| Headquarter of | TRIAD RX, INC. | e4e20479-c083-e911-9175-00155d01b32c | MINNESOTA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1770839771 | 2012-07-27 | 2012-07-27 | PO BOX 1530, DAPHNE, AL, 365261530, US | 26258 POLLARD RD, DAPHNE, AL, 365264250, US | |||||||||||||||||||||||||||||||||||
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| Phone | +1 251-380-7630 |
| Fax | 2513807631 |
Authorized person
| Name | ROBERT ROBERTS |
| Role | PHARMACIST IN CHARGE |
| Phone | 2513807630 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0004X - Compounding Pharmacy |
| License Number | 113869 |
| State | AL |
| Is Primary | Yes |
| Taxonomy Code | 3336M0002X - Mail Order Pharmacy |
| Is Primary | No |
Other Provider Identifiers
| Issuer | NCPDP PROVIDER IDENTIFICATION NUMBER |
| Number | 0138049 |
| Name | Role |
|---|---|
| CORPORATION SERVICE COMPANY, INC. | Agent |
| Name | Role | Address |
|---|---|---|
| MCDONALD, MATT L | Director | 26258 POLLARD ROADDAPHNE, AL 36526 |
| VINKE, BRADLEY A | Director | 2285 COUNTY ROAD 51 NCAMDEN, AL 36726 |
| Name | Role | Address |
|---|---|---|
| MCDONALD, MATT L | Incorporator | 26258 POLLARD ROADDAPHNE, AL 36526 |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
