| Name: | Brewton Medical Center Pharmacy, P.C. |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Professional Corporation |
| Status: | Exists |
| Date of registration: | 15 Jun 1992 (32 years ago) (Companies founded in June 1992) |
| Entity Number: | 000-150-321 |
| Register Number: | 000150321 |
| Place of Formation: | Escambia County |
| Principal Address: | BREWTON, AL |
| Registered Office Street Address: | 1335 MCMILLAN AVENUEBREWTON, AL |
| Authorized Capital: | $10,000 |
| Paid Share Capital: | $10,000 |
Activities
PHARMACY
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1396151924 | 2014-07-02 | 2014-08-04 | 174 HIGHWAY 113, FLOMATON, AL, 364414556, US | 174 HIGHWAY 113, FLOMATON, AL, 364414556, US | |||||||||||||||||||||||||||
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| Phone | +1 251-867-5454 |
| Fax | 2518676117 |
Authorized person
| Name | CHARLES COTTRELL |
| Role | PRESIDENT |
| Phone | 2518020387 |
Taxonomy
| Taxonomy Code | 333600000X - Pharmacy |
| Is Primary | No |
| Taxonomy Code | 3336C0003X - Community/Retail Pharmacy |
| License Number | 114383 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | PK |
| Number | 2146701 |
| Name | Role | Address |
|---|---|---|
| COTTRELL, CHARLES D | Incorporator | 810 EAST CRAIG STREETATMORE, AL 36502 |
| Name | Role | Address |
|---|---|---|
| COTTRELL, CHARLES D | Agent | 810 EAST CRAIG STREETATMORE, AL 36502 |
Date of last update: 01 Aug 2024
Sources: Alabama Secretary of State
