| Name: | Mills Pharmacy at Pleasant Grove, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 17 Feb 2012 (13 years ago) (Companies founded in February 2012) |
| Entity Number: | 000-041-577 |
| Register Number: | 000041577 |
| Historical Names: |
Mills Pills, LLC - Pleasant Grove
|
| ZIP code: | 35188 (Companies in Bibb, 35188) |
| County: | Bibb |
| Place of Formation: | Bibb County |
| Registered Office Street Address: | 2400 MTN DRIVE STE 104HOOVER, AL 35226 |
| Registered Office Mailing Address: | PO BOX 26679BIRMINGHAM, AL 35260 |
| Principal Address: | 19 GEORGIA LOOPWOODSTOCK, AL 35188 |
Activities
PHARMACY BUSINESS
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1891058152 | 2012-06-21 | 2020-04-10 | PO BOX 26679, BIRMINGHAM, AL, 352600679, US | 847 PARK RD STE A, PLEASANT GROVE, AL, 351271676, US | |||||||||||||||||||||||||||||||||
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| Phone | +1 205-871-9007 |
| Fax | 2058749946 |
| Phone | +1 205-744-0447 |
| Fax | 2057440477 |
Authorized person
| Name | JOSH HARDIN |
| Role | PHARMACIST |
| Phone | 2054270955 |
Taxonomy
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 113927 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 150210 |
| State | AL |
| Issuer | PK |
| Number | 2135653 |
| Name | Role | Address |
|---|---|---|
| MILLS, ROBERT WAYNE | Organizer | 758 SHADES MOUNTAIN PLAZAHOOVER, AL 35226 |
| Name | Role | Address |
|---|---|---|
| LONG, BEETINA | Agent | 2087 BANEBERRY DRHOOVER, AL 35244 |
| Event Date | Event Type | Old Value | New Value |
|---|---|---|---|
| 2016-01-15 | Name Change | Mills Pills, LLC - Pleasant Grove | Mills Pharmacy at Pleasant Grove, LLC |
Date of last update: 30 Jul 2024
Sources: Alabama Secretary of State
