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Professional Apothecary, Inc.

Details

Name: Professional Apothecary, Inc.
Jurisdiction: Alabama
Legal type: Domestic Corporation
Status: Exists
Date of registration: 01 Jul 1991 (33 years ago) (Companies founded in July 1991)
Entity Number: 000-143-829
Register Number: 000143829
ZIP code: 35160 (Companies in Talladega, 35160)
County: Talladega
Place of Formation: Talladega County
Principal Address: TALLADEGA, AL
Registered Office Street Address: 210 WEST NORTH STREETTALLADEGA, AL 35160
Authorized Capital: $1,000

Activities PHARMACEUTICAL BUSINESS

National Provider Identifier

NPI Enumeration Date Last Update Date Mailing Address Practice Location Address
1407931827 2006-10-25 2015-02-24 210 NORTH ST W, TALLADEGA, AL, 351602083, US 210 NORTH ST W, TALLADEGA, AL, 351602083, US

Contacts
Phone +1 256-362-8328
Fax 2563628361

Authorized person
Name BLAKE HARRIS
Role PRESIDENT/OWNER
Phone 2563628328

Taxonomy
Taxonomy Code 332B00000X - Durable Medical Equipment & Medical Supplies
Is Primary Yes

Other Provider Identifiers
Issuer BLUE CROSS ALABAMA
Number 51050787
State AL
Issuer MEDICAID
Number 000050787
State AL

form 5500

Plan Name Plan Year EIN/PN Received Sponsor Total number of participants
PROFESSIONAL APOTHECARY, INC. AGE-WEIGHTED PROFIT SHARING PLAN 2014 631046853 2015-06-01 PROFESSIONAL APOTHECARY, INC. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-07-01
Business code 446110
Sponsor’s telephone number 2563624951
Plan sponsor’s address 197 HARRIS LANE, TALLADEGA, AL, 35160

Signature of
Role Plan administrator
Date 2015-06-01
Name of individual signing DAN HARRIS
Role Employer/plan sponsor
Date 2015-06-01
Name of individual signing DAN HARRIS
PROFESSIONAL APOTHECARY, INC. AGE-WEIGHTED PROFIT SHARING PLAN 2014 631046853 2015-04-24 PROFESSIONAL APOTHECARY, INC. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-07-01
Business code 446110
Sponsor’s telephone number 2563624951
Plan sponsor’s address 197 HARRIS LANE, TALLADEGA, AL, 35160

Signature of
Role Plan administrator
Date 2015-04-24
Name of individual signing BLAKE HARRIS
Role Employer/plan sponsor
Date 2015-04-24
Name of individual signing BLAKE HARRIS
PROFESSIONAL APOTHECARY, INC. AGE-WEIGHTED PROFIT SHARING PLAN 2013 631046853 2014-06-11 PROFESSIONAL APOTHECARY, INC. 21
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-07-01
Business code 446110
Sponsor’s telephone number 2563628328
Plan sponsor’s address 210 NORTH ST. W., TALLADEGA, AL, 35160

Signature of
Role Plan administrator
Date 2014-06-11
Name of individual signing DAN HARRIS
Role Employer/plan sponsor
Date 2014-06-11
Name of individual signing DAN HARRIS
PROFESSIONAL APOTHECARY, INC. AGE-WEIGHTED PROFIT SHARING PLAN 2012 631046853 2013-06-14 PROFESSIONAL APOTHECARY, INC. 20
Three-digit plan number (PN) 001
Effective date of plan 1991-07-01
Business code 446110
Sponsor’s telephone number 2563628328
Plan sponsor’s address 210 NORTH ST. W., TALLADEGA, AL, 35160

Signature of
Role Plan administrator
Date 2013-06-14
Name of individual signing BLAKE HARRIS
Role Employer/plan sponsor
Date 2013-06-14
Name of individual signing BLAKE HARRIS
PROFESSIONAL APOTHECARY, INC. AGE-WEIGHTED PROFIT SHARING PLAN 2012 631046853 2013-06-14 PROFESSIONAL APOTHECARY, INC. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-07-01
Business code 446110
Sponsor’s telephone number 2563628328
Plan sponsor’s address 210 NORTH ST. W., TALLADEGA, AL, 35160

Signature of
Role Plan administrator
Date 2013-06-14
Name of individual signing BLAKE HARRIS
Role Employer/plan sponsor
Date 2013-06-14
Name of individual signing BLAKE HARRIS
PROFESSIONAL APOTHECARY, INC. AGE-WEIGHTED PROFIT SHARING PLAN 2011 631046853 2012-05-24 PROFESSIONAL APOTHECARY, INC. 20
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-07-01
Business code 446110
Sponsor’s telephone number 2563628328
Plan sponsor’s address 210 NORTH ST. W., TALLADEGA, AL, 35160

Plan administrator’s name and address
Administrator’s EIN 631046853
Plan administrator’s name PROFESSIONAL APOTHECARY, INC.
Plan administrator’s address 210 NORTH ST. W., TALLADEGA, AL, 35160
Administrator’s telephone number 2563628328

Signature of
Role Plan administrator
Date 2012-05-24
Name of individual signing BLAKE HARRIS
Role Employer/plan sponsor
Date 2012-05-24
Name of individual signing BLAKE HARRIS
PROFESSIONAL APOTHECARY, INC. AGE-WEIGHTED PROFIT SHARING PLAN 2010 631046853 2011-06-09 PROFESSIONAL APOTHECARY, INC. 18
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-07-01
Business code 446110
Sponsor’s telephone number 2563628328
Plan sponsor’s address 210 NORTH ST. W., TALLADEGA, AL, 35160

Plan administrator’s name and address
Administrator’s EIN 631046853
Plan administrator’s name PROFESSIONAL APOTHECARY, INC.
Plan administrator’s address 210 NORTH ST. W., TALLADEGA, AL, 35160
Administrator’s telephone number 2563628328

Signature of
Role Plan administrator
Date 2011-06-09
Name of individual signing BLAKE HARRIS
Role Employer/plan sponsor
Date 2011-06-09
Name of individual signing BLAKE HARRIS
PROFESSIONAL APOTHECARY, INC. AGE-WEIGHTED PROFIT SHARING PLAN 2009 631046853 2010-07-02 PROFESSIONAL APOTHECARY, INC. 16
File View Page
Three-digit plan number (PN) 001
Effective date of plan 1991-07-01
Business code 446110
Sponsor’s telephone number 2563628328
Plan sponsor’s address 210 W. NORTH STREET, TALLADEGA, AL, 35160

Plan administrator’s name and address
Administrator’s EIN 631046853
Plan administrator’s name PROFESSIONAL APOTHECARY, INC.
Plan administrator’s address 210 W. NORTH STREET, TALLADEGA, AL, 35160
Administrator’s telephone number 2563628328

Signature of
Role Plan administrator
Date 2010-07-02
Name of individual signing BLAKE HARRIS
Role Employer/plan sponsor
Date 2010-07-02
Name of individual signing BLAKE HARRIS

Agent

Name Role Address
HELMS, CHRISTOPHER B Agent 210 NORTH STREET W #ATALLADEGA, AL 35160

Incorporator

Name Role
HARRIS, DAN BLAKE III Incorporator

Related by officers

HELMS, CHRISTOPHER B

Pro Apo Leasing & Management, Inc.

Related by address

TALLADEGA, AL

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Date of last update: 01 Aug 2024

Sources: Alabama Secretary of State

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