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Bolling Apothecary, Inc.

Details

Name: Bolling Apothecary, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Dissolved
Date of registration: 19 May 1988 (37 years ago) (Companies founded in May 1988)
Date of dissolution: 05 Mar 2020
Entity Number: 000-124-118
Register Number: 000124118
ZIP code: 35555 (Companies in Fayette, 35555)
County: Fayette
Place of Formation: Fayette County
Principal Address: FAYETTE, AL
Registered Office Street Address: 106 16TH ST NEFAYETTE, AL 35555
Authorized Capital: $5,000

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1447356324 2006-09-16 2007-08-31 106 16TH ST NE, FAYETTE, AL, 355551340, US 106 16TH ST NE, FAYETTE, AL, 355551340, US

Contacts
Phone +1 205-932-8969
Fax 2059328095

Authorized person
Name RICK BOILLING
Role OWNER
Phone 2059328969

Taxonomy
Taxonomy Code 332B00000X - Durable Medical Equipment & Medical Supplies
Is Primary No
Taxonomy Code 333600000X - Pharmacy
Is Primary No
Taxonomy Code 3336C0003X - Community/Retail Pharmacy
License Number 101665
State AL
Is Primary Yes
Taxonomy Code 3336C0004X - Compounding Pharmacy
Is Primary No

Other Provider Identifiers
Issuer MEDICAID
Number 00001717
State AL
Issuer OTHER ID NUMBER
Number 0116207

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
BOLLING APOTHECARY, INC. 401(K) P/S PLAN 2011 630979792 2012-09-25 BOLLING APOTHECARY, INC. 23
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 446110
Sponsor’s telephone number 2059328969
Plan sponsor’s address 106 16TH STREET, NE, FAYETTE, AL, 35555

Plan administrator’s name and address
Administrator’s EIN 630979792
Plan administrator’s name BOLLING APOTHECARY, INC.
Plan administrator’s address 106 16TH STREET, NE, FAYETTE, AL, 35555
Administrator’s telephone number 2059328969

Signature of
Role Plan administrator
Date 2012-09-25
Name of individual signing LENA FULMER
BOLLING APOTHECARY, INC. 401(K) P/S PLAN 2011 630979792 2012-10-04 BOLLING APOTHECARY INC. 15
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 446110
Sponsor’s telephone number 2059328969
Plan sponsor’s address 106 16TH STREET, NE, FAYETTE, AL, 35555

Plan administrator’s name and address
Administrator’s EIN 630979792
Plan administrator’s name BOLLING APOTHECARY INC.
Plan administrator’s address 106 16TH STREET, NE, FAYETTE, AL, 35555
Administrator’s telephone number 2059328969

Signature of
Role Plan administrator
Date 2012-10-04
Name of individual signing LENA FULMER
BOLLING APOTHECARY, INC. 401(K) P/S PLAN 2010 630979792 2011-03-22 BOLLING APOTHECARY INC. 13
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 446110
Sponsor’s telephone number 2059328969
Plan sponsor’s address 106 16TH STREET, NE, FAYETTE, AL, 35555

Plan administrator’s name and address
Administrator’s EIN 630979792
Plan administrator’s name BOLLING APOTHECARY INC.
Plan administrator’s address 106 16TH STREET, NE, FAYETTE, AL, 35555
Administrator’s telephone number 2059328969

Signature of
Role Plan administrator
Date 2011-03-22
Name of individual signing LENA FULMER
BOLLING APOTHECARY, INC. 401(K) P/S PLAN 2009 630979792 2010-07-27 BOLLING APOTHECARY INC. 11
File View Page
Three-digit plan number (PN) 001
Effective date of plan 2006-01-01
Business code 446110
Sponsor’s telephone number 2059328969
Plan sponsor’s address 106 16TH STREET, NE, FAYETTE, AL, 35555

Plan administrator’s name and address
Administrator’s EIN 630979792
Plan administrator’s name BOLLING APOTHECARY INC.
Plan administrator’s address 106 16TH STREET, NE, FAYETTE, AL, 35555
Administrator’s telephone number 2059328969

Signature of
Role Plan administrator
Date 2010-07-27
Name of individual signing LENA FULMER

Agent

Name Role
BOLLING, GEORGE R Agent

Incorporator

Name Role
BOLLING, GEORGE R Incorporator

Related by officers

BOLLING, GEORGE R

Bolling Pharmacy, Inc. Howell's Funeral Home, Inc.

Related by address

FAYETTE, AL

Alabama Paper Carton Corporation Branyon Oil Company, Inc. Citizens Bank of Fayette R. C. Cobb, Inc. Dixie Dairy Supply Co., Inc. The Marion Davis Company, Inc. Dobbs Brothers Pulpwood Company, Inc. Dowdle Brown Service, Inc. Fayette Furniture Mart Fayette Grain and Feed Company, Inc.

106 16TH ST NEFAYETTE, AL 35555

The Fayette Drug Program, Inc.

Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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