| Name: | HEALTH CLINIC PHARMACY, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 29 Mar 2012 (13 years ago) (Companies founded in March 2012) |
| Entity Number: | 000-048-542 |
| Register Number: | 000048542 |
| ZIP code: | 36601 (Companies in Mobile, 36601) |
| County: | Mobile |
| Place of Formation: | Escambia County |
| Registered Office Street Address: | 810 EAST CRAIG STREETATMORE, AL 36502 |
| Principal Address: | 251 NORTH BAYOU STREETMOBILE, AL 36601 |
Activities
RETAIL
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1598022188 | 2012-04-19 | 2017-03-17 | PO BOX 129, GRAND BAY, AL, 365410129, US | 251 N BAYOU ST, MOBILE, AL, 366035827, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 251-865-1040 |
| Fax | 2518651041 |
| Phone | +1 251-690-8817 |
| Fax | 2515442157 |
Authorized person
| Name | CHARLES COTTRELL |
| Role | PRESIDENT |
| Phone | 2518675454 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 113150 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2135246 |
| Issuer | MEDICAID |
| Number | 138255 |
| State | AL |
| 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
